 Previously seen patchy areas of abnormal T2/STIR hyperintensity throughout the cervical cord are similar except for interval left lateral involvement at the C2-C3 level. Previously, areas of abnormal signal were often associated with mild cord expansion. This is resolved, with minimal if any areas of slight decreased cord volume. Additional patchy abnormal signal extends into the medulla, where previous discrete oval lesions were identified.The cervical spine is in normal alignment, with mild reversal of the normal cervical lordosis centered at C4-C5. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated.At C4-C5 and C5-C6, there are very shallow left paracentral disc protrusions without stenosis, which appear new since the prior exam.THORACIC SPINE
1. Patchy abnormal signal throughout the cervical and thoracic cord consistent with known demyelinating disease. Overall, previously expanded areas of cord abnormality and decreased, with scattered mild areas of volume loss suggested. Mild expansion of the cord at the T8 level which may indicate more recent plaque. Left lateral involvement at C2-C3 appears to be new since the prior exam.2. Mild spondylotic changes as detailed above without high-grade stenosis at any level.