 There is new mild increased T2 signal within the paravertebral soft tissues posteriorly from the C4/5 through C 6/7 levels associated with slight increased signal in the interspinous ligament at C6/7 (best seen sagittal STIR technique).Previously identified Modic type I discogenic reactive endplate changes at C6-C7 and to a lesser extent C5-C6 now appear as Modic type II. As before, there is multilevel disk desiccation and loss of disk height. Minimal grade 1 retrolisthesis of C5 on C6 is unchanged. There are no acute fractures. The marrow signal is benign. The cervical and upper thoracic cord are normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable. Right mastoid fluid is unchanged.C1/2: No significant central canal stenosis or neuroforaminal narrowing, unchanged.C2/3: No significant central canal stenosis or neuroforaminal narrowing, unchanged.C3/4: Posterior disk osteophyte complex eccentric to the right has progressed resulting in increased right anterior hemicord flattening, yet still without intrinsic T2 cord signal abnormality. As before, there is bilateral uncovertebral hypertrophy and mild facet hypertrophy resulting in mild to moderate left neural foraminal and moderate to severe right neural foraminal stenosis, unchanged. There is no significant central canal stenosis.C4/5: Posterior disk osteophyte complex, left facet hypertrophy, and posterior ligamentous hypertrophy resulting in bilateral neuroforamina narrowing, mild to moderate on the right and moderate to severe on the left, unchanged. No significant central canal stenosis.C5/6: Posterior disk osteophyte complex, facet hypertrophy, posterior ligamentous hypertrophy resulting in severe right and moderate left neuroforaminal narrowing, unchanged. There is effacement of the CSF space resulting in mild central canal stenosis, unchanged.C6/7: Posterior disk osteophyte complex, facet hypertrophy, uncovertebral hypertrophy, and posterior ligamentous hypertrophy resulting in mild central canal stenosis and mild to moderate bilateral neuroforaminal narrowing, left greater than right, unchanged.C7/T1: Facet hypertrophy results in mild left neuroforaminal narrowing, unchanged. No significant central canal stenosis.
1.There is new mild increased T2 signal within the paravertebral soft tissues posteriorly from the C4/5 through C 6/7 levels associated with slight increased signal in the interspinous ligament at C6/7. The differential diagnosis for this would include injury if there is been a recent history of trauma or in absence of this history an inflammatory process of uncertain etiology or significance.2.C3/4: Posterior disk osteophyte complex eccentric to the right has progressed resulting in increased right anterior hemicord flattening, yet still without intrinsic T2 cord signal abnormality. Mild to moderate left neural foraminal and moderate to severe right neural foraminal stenosis is unchanged. 3.C4/5: Bilateral neuroforamina narrowing, mild to moderate on the right and moderate to severe on the left, unchanged.4.C5/6: Severe right and moderate left neuroforaminal narrowing, unchanged. Mild central canal stenosis is unchanged.5.C6/7: Mild central canal stenosis and mild to moderate bilateral neuroforaminal narrowing, left greater than right, unchanged.6.C7/T1: Mild left neuroforaminal narrowing, unchanged.