1-Cord pathology in case of degenerative disease should be in place related to the disc of ligamenta flava.
2-Causes of cord pathology:
-Edema.
-Early myelomalacia.
-Late myelomalacia.
The problem here is that the three pathologies mentioned above gives hyper intense focal area in T2 MRI image.
In the past, they mentioned that the edema makes the cord enlarged while the myelomalacia makes it thin is not accurate because you needs large cord edema to see the cord enlarged.
To differentiate between early and late myelomalacia, give contrast injection, if you see marginal enhancement, this means early myelomalacia which will be improved after decompression while if no enhancement seen, this means late myelomalacia which will not be relieved by decompression.
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