 No worrisome focal marrow signal abnormality is appreciated in the cervical spine to suggest metastatic disease within the limitations of a noncontrast exam. There is minimal retrolisthesis of C3 on C4, and minimal anterolisthesis of C6 on C7 and C7 on T1. The vertebral body and disk heights are well-maintained. The spinal cord is of normal caliber and signal. Lesions of the right clivus/basiocciput, and left occipital condyle are partially imaged and better evaluated on recent contrast enhanced brain MRI. There is STIR hyperintense lesions involving the T2 vertebral body as well as the partially imaged T3 vertebral body extending into the left pedicle which have progressed since 4/15/2016.At C2-C3, there is moderate right facet arthropathy. There is no significant spinal canal or neuroforaminal stenosis.At C3-C4, there is moderate posterior disc osteophyte complex, uncovertebral hypertrophy, right greater than left, and facet arthropathy. There is mild central canal stenosis. There is moderate right and mild left neuroforaminal stenosis.At C4-C5, there is mild posterior disc osteophyte complex and uncovertebral hypertrophy as well as mild facet arthropathy. There is no significant spinal canal or neuroforaminal stenosis.At C5-C6, there is right greater than left uncovertebral hypertrophy and posterior disc osteophyte complex and mild facet arthropathy. There is effacement of the right lateral recess but no overall significant spinal canal stenosis. There is moderate to severe right and no significant left neuroforaminal stenosis.At C6-C7, there is mild posterior disc osteophyte complex and mild facet arthropathy, left greater than right. There is no significant spinal canal or neuroforaminal stenosis.At C7-T1, there is mild left uncovertebral hypertrophy and moderate bilateral facet arthropathy. There is no significant spinal canal or neuroforaminal stenosis.
1.Skull base metastases are partially imaged and better evaluated on recent contrast-enhanced brain MRI.2.No definite evidence of metastatic disease in the cervical spine within the limitations of a noncontrast exam. There are however new lesions at the T2 and T3 levels compared to 4/15/2016 which are partially imaged. T3 lesion extends into the left pedicle. These lesions are present on recent CT chest abdomen pelvis from 7/24/2016.3.Multilevel cervical degenerative changes, as above, with facet arthropathy relatively worse at the right C2-3 and bilateral C7-T1 levels and multilevel neuroforaminal stenoses, most prominent at the right C3-C4 and right C5-6 levels.