Recent motor vehicle accident. Neck stiffness and decreased range of motion. Also, low back pain and stiffness with history of spondylolisthesis. The examination is mildly limited by patient's body habitus.CERVICAL SPINE:Included brain is notable for a partially empty sella which might be an incidental finding unless there are other manifestations of elevated intracranial pressure.Sagittal alignment is notable for straightening, which may reflect patient positioning. The vertebral bodies are preserved in height. Marrow signal is benign. There is disc desiccation at all levels. The spinal canal is preserved other than shallow ventral indentations by discs as described below. There is no epidural hematoma. The spinal cord shows normal shape and signal. STIR imaging shows no increased signal in the adjacent soft tissues.C2-C3: There is no spinal canal or neural foraminal stenosis.C3-C4: Shallow central ventral indentation of the thecal sac by small disc-osteophyte complex but no significant stenosis. There is mild right neural foraminal narrowing by uncovertebral arthropathy.C4-C5: There is shallow ventral indentation of the thecal sac by small disc-osteophyte complex but no significant stenosis. There is uncovertebral and facet arthropathy but no significant foraminal stenosis.C5-C6: Similarly, there is shallow ventral indentation of the thecal sac by disc-osteophyte complex but no significant spinal canal stenosis. There is mild right neural foraminal stenosis related to uncovertebral and facet arthropathy.C6-C7 and C7-T1: There is no significant spinal canal or neural foraminal stenoses.Included on sagittal imaging only are T1-T2, T2-T3 and T3-T4 levels, which show no significant spinal canal or foraminal stenoses.LUMBAR SPINE:There is transitional anatomy with 5 lumbar type vertebral bodies as well as a sixth lumbarized segment labeled S1 for the purposes of this study. Sagittal alignment is notable for an 8 mm/grade 2 anterolisthesis of L5 relative to S1 with bilateral L5 pars defects. There is increased fatty signal in the marrow along the endplates and along pars interarticularis defects. This is associated with severe disc height loss. The vertebral bodies are preserved in height. In addition to the severe fatty endplate reactive changes at L5-S1 levels, there is degenerative mild-to-moderate height loss at L1-L2 associated with type II/fatty degenerative marrow changes subjacent to the endplates anteriorly. The spinal canal is preserved at the other levels. The conus medullaris tip lies at L1-L2 level. The conus medullaris shows normal signal and shape.T11-T12 is included only on sagittal imaging without significant spinal canal or neural foraminal stenosis.T12-L1: There is no significant spinal canal or neural foraminal stenosis.L1-L2: Degenerative disc and osteophyte flattens the anterior aspect of the thecal sac but causes no significant spinal canal stenosis. Also there is mild facet arthropathy but no significant neural foraminal stenosis.L2-L3, L3-L4 and L4-L5 mild facet arthropathy but no significant spinal canal or neural foraminal stenosis.L5-S1: The spondylolytic anterolisthesis and associated advanced disc/endplates and facet degenerative changes result in effacement of the right lateral recess but no significant central spinal canal stenosis. There is also severe right and moderate left neural foramen stenoses.
1.There is no MR evidence of traumatic injury in the cervical spine.2.Cervical spine demonstrates minimal degenerative changes without significant spinal canal stenosis and only mild right foraminal stenoses as described above. 3.Lumbar spine: Please note variant anatomy with a lumbarized transitional segment labeled S1 for the purposes of this study. As numbered there is grade 2 spondylolytic anterolisthesis of L5 relative to the lumbarized S1 associated with severe right and moderate left neural foraminal stenoses. There is also effacement of the right lateral recess at this level without significant central canal stenosis. 