Numbness in hands, recurrent stenosis? History of foraminotomy. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. Kyphotic angulation again seen at C3-4 which is unchanged. Alignment is otherwise maintained. Bone marrow signal is benign.The cervical spinal cord has normal signal characteristics and overall morphology. There is evidence of prior left-sided foraminotomies at C4-C5, C5-C6, and C6-C7.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Mild disk osteophyte complex and kyphotic attenuation with partial effacement of the ventral thecal sac. No significant compromise to the spinal canal or neural foramina. C4-5: Again seen is uncovertebral hypertrophy and facet hypertrophy greater on the left with interval postsurgical changes of left-sided foraminotomy. No significant spinal canal or right foramina stenosis.C5-6: There is small disk osteophyte complex with bilateral uncovertebral hypertrophy and facet arthropathy. Interval postsurgical changes of left-sided foraminotomy. There is moderate right-sided foraminal narrowing related to uncovertebral hypertrophy and right-sided extrusion which is minimally worsened in the interval. There is associated effacement of the right ventral thecal sac, otherwise no significant spinal canal stenosis. C6-7: Interval left-sided foraminotomy. Again seen is prominent left-sided uncovertebral spur with small disk component. Spinal canal and right neural foramen appear patent.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Degenerative changes in the cervical spine with interval left-sided foraminotomies at the left C4-C5, C5-C6, and C6-C7 levels compared to 4/8/2014. There is no new disk extrusion on the left to explain recurrent symptoms. There may some residual foraminal narrowing despite the foraminotomy which could be further assessed with CT to better define the osseous anatomy if surgery is contemplated.Minimal interval increase in disk extrusion at the right C5-C6 level with associated effacement of the right ventral thecal sac and moderate right foraminal stenosis.