Bilateral lower extremity weakness, evaluate for cord compression Again seen are postsurgical changes of cervical laminoplasty with laminectomies from C3 to C7, spinous processes resection, and placement of bone graft at the C4 and C6 levels on the left. There are foci of T2 hyperintensity involving the right lateral aspect of the cord at the C5-C6 and C6-C7 levels with volume loss consistent with myelomalacia, and similar to 6/8/2015. Vertebral body heights are maintained. Reversal of cervical lordosis again seen as well as trace retrolisthesis of C4 on C5 and C5 on C6.Multilevel degenerative changes are seen, individual levels as below:C2/3: No significant neural foraminal or central canal stenosis.C3/4: Diffuse disc bulge results in effacement of the ventral thecal sac and minimal indentation of the ventral cord. Dorsal thecal sac is patent. Uncovertebral hypertrophy results in moderate left and mild right neural foraminal stenoses. C4/5: Disk osteophyte complex and ligamentum flavum thickening result in partial effacement of the ventral and dorsal thecal sac and overall mild spinal canal stenosis. There is severe right and moderate to severe left neural foraminal narrowing.C5/6: Disc osteophyte complex is present without significant spinal canal stenosis. Uncovertebral hypertrophy results in mild to moderate left and moderate to severe right neural foraminal stenoses.C6/7: Disc osteophyte complex is associated with effacement of the ventral and dorsal thecal sac, particularly on the right. Severe right and moderate to severe left neural foraminal stenosis again seen related to uncovertebral hypertrophy. C7/T1: Mild disc bulge and ligamentum flavum thickening without significant spinal canal or neural foraminal stenosis.
1. Postoperative changes of C3-C7 cervical laminoplasty are again seen. Spinal canal caliber is improved when compared to preoperative MRI from 2/14/2015. There does remain however mild degree of spinal canal stenosis/thecal sac effacement at C3-C4, C4-C5, and to a slightly greater degree relatively at C6-C7 levels, similar to prior from 6/8/2015.2. T2 hyperintensity in the right lateral cord at the C6-C7 level and to a lesser degree C5-C6 level related to myelomalacia as seen before.