Dr. Manorama Rajan (Neurology) needs a second opinion on this medical case.
66 yr ,M, presented with mudthorasic pain of 2 weeks, stiffness and buckling of knees for 10 days,mild hesitancy in passing urine for 1 week.
Mid thoracic pain is intermittent ,more on lying down and sitting positions. Sneezing and coughing used to aggravate the pain.For the last 10 days he has heaviness of both legs ,left more than right with bucking of the knees while walking.Able to pass urine and the sensation of micturition is intact but taking time to initiate micturition.
Known case of perampullary CA pancreas,on regular follow up.
On exam vitals stable. Bp140/ 80 mmhg Motor system gr4/5 power both lower limbs. All other groups were normal . Adductor spasticity both sides.Bilateral hyperreflexes for knee and ankles .Abdominal reflexes absent with flexor plantars. Dulling of sensations all modalities from D8 down.
What abnormality in the MRI spine, Diagnosis with management?