Left upper extremity weakness and neck pain. C4-C5 fusion. Multiple sequences are motion degraded and repeated. Again seen are postoperative changes of ACDF at C4-C5 with solid osseous fusion better demonstrated on CT. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits. Susceptibility artifact from patient's hardware and motion degradation somewhat limit evaluation. There is abnormal T2 signal involving the right ventral aspect of the cord at the C4-C5 level likely representing myelomalacia, presumably from prior compressive myelopathy. There is no spinal canal stenosis on the current study at this level.There is mild developmental narrowing of the cervical spinal canal with superimposed degenerative changes including small disc osteophyte complexes and mild multilevel facet arthropathy. Individual levels as below:C2-3: No significant compromise to the spinal canal or neural foramina. Mild facet arthropathy.C3-4: Small disc osteophyte complex and uncovertebral hypertrophy. There is partial effacement of the ventral and dorsal thecal sac without significant spinal canal stenosis overall. There is mild to moderate right and mild left left neural foraminal stenosis related to uncovertebral hypertrophy and facet arthropathy.C4-5: No significant compromise to the spinal canal or neural foramina. Cord signal abnormality as described above.C5-6: There is a small disc osteophyte complex and ligamentum flavum thickening contributing to mild spinal canal stenosis. There is up to moderate, right slightly worse than left neural foraminal stenosis.C6-7: No significant compromise to the spinal canal. Minimal bilateral neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.
1. Postoperative changes of ACDF at C4-C5, with solid osseous fusion better demonstrated on CT.2. Degenerative changes in the cervical spine superimposed on mild developmental narrowing of the cervical spinal canal. There is mild spinal canal stenosis at the C5-C6 level. Otherwise no evidence of high-grade spinal canal stenosis. Neural foraminal stenosis is worst at the C5-C6 level where there may be impingement of the C6 nerve roots, right worse than left.3. Abnormal T2 signal involving the right ventral cord at the C4-C5 level likely represents myelomalacia and may be related to prior compression. There is no spinal canal stenosis on the current study at this level..