 BRAIN:No intracranial mass or mass-effect. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are a few scattered periventricular and subcortical white matter T2 hyperintensities which are nonspecific. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. CERVICAL SPINE:There are postoperative changes of C3 through C7 laminoplasty which are new from the prior MRI but similar to the CT of 7/15/2014. There is interval increase in CSF space dorsally. There is anterior fusion from C5 through C7 with anterior plate and screws. Evaluation of this region is limited due to susceptibility artifact. There are intervertebral spacers at C5-C6 and C6-C7. Desiccation and C3-C4 is unchanged. Mild straightening of the cervical spine appear similar to the prior exam. Subtle increased T2 signal from C4-6 is again seen and may suggest mild gliosis. No new cord signal abnormality.C1-C2: No spinal canal stenosis or neuroforaminal narrowing.C2-C3: Small central posterior disk osteophyte complex without spinal canal or neuroforaminal stenosisC3-C4: Small left central posterior disk osteophyte complex. Mild narrowing of the spinal canal, improved from the prior exam. No neuroforaminal stenosis.C4-C5: Central posterior disk osteophyte complex with mild ligamentous thickening. Mild impression on the ventral cord again seen with increase in CSF space dorsally related to decompressive surgery. Moderate to severe right and mild left neuroforaminal stenosis. C5-C6: Small central posterior disk osteophyte complex. There is mild effacement of the ventral thecal sac, however central canal narrowing seen previously has improved. Moderate left and mild right neuroforaminal narrowing, unchanged.C6-C7: Mild thickening of the posterior longitudinal ligament. No significant central or neuroforaminal stenosis.C7-T1: No significant central or neuroforaminal stenosis.Right paraspinal cysts at the level of the right lung apex is unchanged.
1. Postsurgical changes of C3 through C7 laminoplasty and anterior fusion of C5 through C7 with overall improvement in caliber of the spinal canal post laminoplasty. 2. There is mild indentation of the ventral cord at C4-5 as was seen previously. Subtle increased T2 signal from C4-6 is again seen and may suggest mild gliosis. No new cord signal abnormality. 3. Moderate neural foraminal stenosis on the right at C4-5 and on the left at C5-6 as seen previously.4. Few scattered periventricular and subcortical white matter T2 hyperintensities which are nonspecific and favored to represent mild chronic small vessel ischemic changes. 