Diagnosis: Quadriplegia, C5-C7 incompleteClinical question: s/p spinal cord bxSigns and Symptoms: weakness The cervical vertebral bodies are appropriate in overall alignment and height. The patient is status post recent multilevel laminectomies at C5, C6, C7. There is redemonstration of a T2 hyperintense mass extending from the C5-6 disc space level down to the T1 vertebral level. There is some heterogeneous enhancement associated with this lesion which is eccentric towards the right half of the spinal cord. The spinal cord is enlarged at the level of the tumor. There is no spinal fluid surrounding the spinal cord at the levels of the tumor.There are signal changes and contrast enhancement along the paravertebral musculature extending from approximately C1 down to T1 which are probably related to partial operative effects.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina.At C4-5 there is no significant compromise to the spinal canal or neural foramina.At C5-6 there is loss of disc space height, endplate reactive change, central disc protrusion, endplate and uncovertebral osteophytes and narrowing of the neural foramina bilaterally and encroachment of exiting nerve roots. The endplate reactive changes are high signal on T2 and display enhancement following gadolinium administration.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina. There are endplate and uncovertebral osteophytes present at this level associated with a disc bulge associated with endplate reactive change.The vertebral artery flow voids appear to be intact.
1.The patient is status post recent laminectomies in the lower cervical spine. There are associated postoperative changes present.2.There is a mass redemonstrated which is centered in the lower cervical spinal cord and eccentric to the right side. Differential considerations include astrocytoma and ependymoma.3.There are multilevel degenerative changes present in the cervical spine associated with the encroachment of exiting nerve roots bilaterally at C5-6. Spinal stenosis at the C5-6 level has been alleviated compared to the prior exam.