Multiple sclerosis. Lumbar stenosis. MRI thoracic spine: There is redemonstration of fairly extensive patchy T2 hyperintense foci of the spinal cord with areas of volume loss. Lesions are most prominent at the left aspect of the T4-T5 level, right aspect of the T5-T6 level, left aspect of T9-T10 and right aspect of T10-T11. On post enhanced images there is no convincing evidence of an enhancing plaque. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable.MRI of lumbar spine: The vertebral column is straightened but otherwise within normal limits in alignment. The vertebral body heights are preserved. There is disc desiccation at L4-L5 and L5-S1 and to a lesser degree at L3-L4 as before. Conus is in normal position.There is no significant spinal canal or neural foraminal stenosis at L1-L2 or L2-L3. At L3-L4, there is a disc bulge eccentric to the right with minimal narrowing of the right neural foramen as before. Otherwise no significant spinal canal or neural foraminal stenosis.At L4-L5, there is disc bulge eccentric to the right which contacts the right L4 nerve root extraforaminally. Otherwise no significant spinal canal or neural foraminal stenosis.At L5-S1: There is central and left paracentral disc protrusion which partially effaces the left lateral recess and contacts the left S1 nerve root similar to 11/30/2015. Disc herniation at this level is significantly improved when compared to 5/2/2015. Mild left neural foraminal stenosis similar to prior. Central spinal canal and right neural foramen remain patent.No suspicious enhancement. The paravertebral soft tissues are unremarkable. Again noted is a leiomyomatous uterus.
1. Patchy T2 hyperintensity throughout the thoracic cord consistent with known demyelinating disease. No new lesion or enhancement within the extensive background of T2 signal abnormality is definitively appreciated.2. Degenerative changes in the lumbar spine are not significantly changed since 11/30/2015. Please see above for more details.