What is the cause of the patient's presentation?
T2 flow voids in the upper lumbar canal are very suspicious for a spinal vascular malformation.
What are the main types of spinal vascular malformations?
(1) Spinal arteriovenous fistulas (AVF), and (2) spinal arteriovenous malformations (AVMs). Spinal AVFs are more common (70%) than spinal AVMs (30%).
What is the next best test?
Cervical and thoracic MRI looking for a nidus and further evidence of a vascular malformation.
No significant degenerative change, disc protrusion or central/foraminal narrowing. Prominent T2 flow voids around the distal spinal cord.