Clinical question: 69-year-old female with back/trunk pain and intermittent incontinence. Signs and symptoms: As above. Pre and postcontrast enhanced thoracic MRI:Examination demonstrates normal signal intensity and the alignment of vertebral column.Examination demonstrates mild degenerative changes of disc and the posterior elements are present.There is no evidence of a spinal canal or neural foraminal compromise or stenosis at any level.There is normal signal intensity and caliber of the thoracic cord.There is no detectable abnormal enhancement of the vertebral column, cord or the meninges.No detectable. Spinal soft tissue abnormalities.Pre- and post enhanced lumbar MRI:There is normal anatomical alignment of vertebral column.T12-L1 is unremarkable.L1-L2 demonstrate mild degenerative changes and which shallow bulging disc however without spinal stenosis or neural foraminal compromise.L2-L3 demonstrate mild disc disease and loss of disc height, shallow broad-based bulging disc, moderate ligamentum flavum and mild facet hypertrophic changes. There is a tiny right perimedian disc protrusion with expected minimal enhancement.Constellation of changes results in moderate central spinal stenosis however without neural foraminal compromise.L3-L4 demonstrate moderate disc disease and loss of disc height, moderate ligamentum flavum and mild bilateral facet hypertrophic changes. Constellation of changes results in moderate central spinal stenosis without neural foraminal compromise.L4-L5 demonstrate moderate disc disease and loss of disc height, mild to moderate left ligamentum flavum hypertrophy and mild bilateral facet hypertrophic changes. There is evidence of a right-sided prior laminectomy with resultant expansion of thecal sac and no central spinal stenosis. There is a large right lateral disc osteophyte at this level which results in right lateral recess compromise however without neural foraminal compromise.L5-S1 demonstrates significant loss of disc height and suggestion of fusion of L5 and S1. There is evidence of prior laminectomy with resultant expansion of thecal sac and without spinal stenosis or neural foraminal compromise.Unremarkable post enhanced images.
1.Pre- and post enhanced thoracic MRI demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise. Normal signal intensity of the cord. No detectable abnormal enhancement.2.Pre- and post enhanced MRI of lumbar spine demonstrate degenerative changes at L2-L3 and L3-L4 levels with resultant moderate central spinal stenosis (worse at L2-L3) without neural foraminal compromise. Postoperative changes of laminectomy at L4-L5 and L5-S1 levels without evidence of central spinal stenosis. Right lateral disc-osteophyte complex at L4-L5 with resultant right lateral recess compromise.