Woman with Backache

Mrs Valantine 50 year old housewife presented with backache for 1 month duration.She was previously well &  Backache has insidious onset which gradually worsened.She felt pain on the lower dorsal region.Not only that  but she complains of a band like constricting type pain going around her chest just below the costal margin.Initially the pain occured with movements.then experienced pain even at the rest.There was loss of appetite also.

No Hx of Trauma.She was not on long term drug Rx.

On examination

She had Localized Tenderness over the Dorsal Spine

She was found to have the signs of cord compression below the level of T10-11 vertebrae.

In other Systems there was no other abnormality detected.

These Investigations were done

HB - 13.5g/dl

WBC - 9800/ml

PLT - 252,000

ESR - 134mm/1 hour

AST - 12U/l

ALT - 17U/l

MRI Scan of the Thoraco - Lumbar Spine was done.

1. What are the Changes that you can appreciate in this MRI Scan???
2. What are the Symptoms & Signs of Cord Comperssion???
3. What are the possible causes for her chronic back pain???
4. How would you confirm the Dx???
5. What Are the Rx option available for this patient & how you Mx this Patient???