 Partially imaged cervical spine demonstrates postsurgical changes of prior anterior cervical fusion extending from C3 to C6. There is a disc bulge at the C6-C7 level with moderate spinal canal stenosis, more completely assessed on prior outside cervical spine study. There is suggestion of T2 hyperintensity involving the right aspect of the cord at the C6 level on the outside study which may be related to prior injury.Thoracic spine:The thoracic spine is in normal alignment. The vertebral body heights are maintained. There are ventral flowing osteophytes at multiple levels suggestive of diffuse idiopathic skeletal hyperostosis. There is T1 hyperintensity involving the disc spaces, particularly at T6-T7 and T10-T11 which be related to mineralization/calcification and can be confirmed on CT. There is T1 hyperintensity involving the vertebral body bone marrow at T8, T9, and superior aspect of T10 with associated enhancement. There is edema involving the disc space at the T7-T8 disc space with T2 hyperintensity and enhancement.There is prominence of the epidural fat extending from T5-T6 to T9-T10 levels. There is associated severe spinal canal stenosis with flattening of the thoracic cord from T6-T7 to T9-T10. Small T8-T9 disc bulge contributes slightly to the stenosis. There is suggestion of subtle T2 hyperintensity in the cord.Abnormal epidural enhancement is noted from T7-T8 to to the T9-T10 levels. There is also prominent paraspinous enhancement from T7-T8 to T9-T10 surrounding the bulky ventral and lateral osteophytes at this level.There is mild to moderate neural foraminal stenosis at T8-T9 bilaterally. Otherwise no significant neural foraminal stenosis in the thoracic spine.Lumbar Spine:Vertebral bodies in the lumbar spine are normal. Alignment is normal. Bone marrow signal is diffusely heterogeneous which is nonspecific but without discrete suspicious lesions evident. There is epidural lipomatosis narrowing the lumbar spinal canal, worst at the L4-L5 level. Individual levels as below:L1-L2: Minimal disc bulge. No significant foraminal stenosis. Minimal spinal canal narrowing related to epidural fat.L2-L3: Mild disc bulge and facet arthropathy. There is mild to moderate spinal canal stenosis related to epidural lipomatosis. No significant neural foraminal stenosis. L3-L4: Mild disc bulge and facet arthropathy. There is moderate spinal canal stenosis related to epidural lipomatosis. No significant neural foraminal stenosis. L4-L5: Diffuse disc bulge, bilateral facet arthropathy with distention of the left facet. There is moderate to severe spinal canal stenosis primarily related to epidural lipomatosis. Mild bilateral neural foraminal stenosis.L5-S1: Minimal disc bulge. Advanced bilateral facet arthropathy. There is moderate to severe spinal canal stenosis related to epidural lipomatosis. There is no significant neural foraminal stenosis.There is edema and enhancement surrounding the L4-L5 and to a lesser degree L5-S1 facet joints, likely on a degenerative basis.
1. Severe spinal canal stenosis with mild flattening of the cord from T6-T7 to the T9-T10 levels related to epidural lipomatosis. There is suggestion of associated subtle T2 cord signal abnormality. Epidural lipomatosis is also evident in the lumbar spine with moderate to severe spinal canal stenosis at the L4-L5 and L5-S1 levels.2. Multiple ventral flowing osteophytes suggestive of diffuse idiopathic skeletal hyperostosis (DISH). There is abnormal enhancement involving the T8-T10 vertebral bodies, T7-T8 disc and to a lesser degree adjacent intervertebral discs, abnormal epidural enhancement from T7-T8 to T9-T10, as well as abnormal paraspinous enhancement from T7-T8 to T9-10 levels surrounding the large thoracic osteophytes. These findings are favored to be on a degenerative basis and/or related to arthropathy such as DISH or CPPD. Much less likely enhancement is related to infection or neoplastic process. Facet arthropathy at L4-L5 and to a lesser degree L5-S1 is also evident with adjacent soft tissue enhancement; these findings are also likely on a degenerative basis.3. Partially imaged cervical spine demonstrates prior anterior cervical fusion from C3 to C6. There is a disc bulge at the C6-C7 level with moderate spinal canal stenosis, more completely assessed on prior outside cervical spine study. There is suggestion of T2 hyperintensity involving the right aspect of the cord at the C6 level on the outside study which may be related to prior injury.4. Mild to moderate neural foraminal stenosis at bilaterally T8-T9. Mild bilateral L4-L5 neural foraminal stenosis. Otherwise neural foramina in the thoracic and lumbar spine are patent.