Demyelinating cervical cord lesions, left leg weakness and neuropathic pain. Evaluate for progression. Cervical: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is some loss of cervical lordosis and mild retrolisthesis of C5 on C6 similar to prior. Degenerative changes are seen in the cervical spine relatively worse at the C5-C6 level where there is a disc osteophyte complex and bilateral uncovertebral hypertrophy producing moderate right and mild left neural foraminal stenosis as well as mild spinal canal stenosis. There is also moderate right C6-C7 neural foraminal narrowing. Bone marrow signal is benign. Paraspinous soft tissues are unremarkable.Multiple T2 hyperintense lesions are again seen in the cervical cord. These include left lateral aspect of the cord at the C3-C4 level, left lateral C4-C5 level, and the right ventral C3 level. There is no appreciable change compared to 1/16/2010. No new lesions.Thoracic: Thoracic cord is normal in signal and contour. Thoracic vertebral body heights are maintained. Alignment is maintained. No significant spinal canal or neural foraminal stenosis is seen. Bone marrow signal is benign with no suspicious lesions. T1 hyperintense lesion at the T2 vertebral body is consistent with a hemangioma. Mild multilevel degenerative changes are seen including a small left paracentral disc protrusion at T6-T7 with mild indentation on the left ventral cord. Dorsal thecal sac is widely patent at this level.
1. No significant change in appearance of the multiple T2 hyperintense lesions within the cervical cord compatible with chronic demyelinating plaques. No new lesion in the cervical cord. No thoracic cord lesions.2. Degenerative changes in the cervical spine with mild spinal canal stenosis at C5-C6 and moderate right neural foraminal stenosis at C5-C6 and C6-C7.