"The pancake sign represents flat, tranverse gadolinium enhancement at the midpoint of a hyperintense, spindle-shaped T2 signal and is seen on sagittal and axial MRI 1,5,6. The axial corollary is formed by circumferential enhancement with sparing the spinal gray matter 2. Of note, the enhancement spans less than one vertebral body and is localised immediately below the point of maximal stenosis. The sign may persist for years 6."