Neuro_MR_Spine: 24 M, peripheral neuropathy and leg weakness, substance abuse.

MRI CERVICAL, THORACIC, AND LUMBAR SPINE WITHOUT CONTRAST:

 

CLINICAL HISTORY: 22-year-old man with back pain, one month of 

peripheral neuropathy and 3-4 days of leg weakness.

 

FINDINGS:

 

Counting from C2, there are five lumbar type vertebral bodies. The 

last well-formed disc is labeled as L5-S1.

 

Localizer image: No visible abnormality.

 

Alignment: Mild rightward curvature of the lower thoracic spine, likely positional.

 

Bone marrow: Diffusely low marrow signal on T1 and T2 weighted images.

 

Vertebrae: Mild disc desiccation in the cervical spine without disc displacement, canal stenosis, or neural foraminal narrowing. Mild degenerative changes of the thoracic spine, including multilevel disc desiccation and loss of intervertebral disc space height,

at T4-T5 effacing the thecal sac and mildly deforming the cord, left paracentral disc protrusion at T7-T8, effacing the thecal sac and mildly deforming the cord. No neural foraminal narrowing in the thoracic spine. Degenerative changes of the lumbar spine manifest by multilevel Schmorl's node formation, disc dessication and disc height loss at L4-L5. Small left paracentral/foraminal disc protrusion at L1-L2, no canal stenosis or neural foraminal narrowing. Status post discectomy at L4-L5, with small residual central disc bulge, mild residual left neural foraminal narrowing and mild bilateral lateral recess stenosis, no 

central canal stenosis, significantly improved from prior exam.

 

Cord and conus: There is

from C2 through C5, with mild associated cord expansion. Conus is normal, terminating at the lower L1 level.

 

Extra-vertebral soft tissues: Normal.

 

Visualized brain: Normal.

 

Visualized chest, abdomen, and pelvis: Normal.

 

Additional comment: None.

 

IMPRESSION:

 

1. Abnormal dorsal column cord signal in the cervical spine from the C2 to C5: consider subacute combined degeneration in light of history of gastric banding. Additional consideration is potential nitrous oxide use as causative or exacerbating etiology of SCD, and clinical history will be informative.

 

2. Diffusely low marrow signal, may be due to regenerative process given renal failure or developing anemia from possible B12 deficiency.

 

3. Mild multilevel degenerative changes of the spine, as described above, status post L4-L5 discectomy, with significant improvement in spinal canal stenosis.