Diagnosis: Cervical disc disorder with myelopathy, unspecified cervical regionClinical question: new symptoms of tingling to hands, increased HNP?Signs and Symptoms: increased/new tinging to hand The cervical vertebral bodies are appropriate in overall alignment and height. The patient status post anterior fusion at C6-7. There is a cord syrinx present measuring up to 1.5 mm in diameter which is unchanged since prior exam. Any subtle differences may be accounted for on the basis of difference in scan technique. There are some subtle T2 signal hyperintensity surrounding the central canal just above the C4-5 disc space level.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There are endplate and uncovertebral osteophytes present at this level associated with the mild encroachment of left-sided exiting nerve roots. This has not changed substantially when compared to the prior exam.At C4-5 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with bilateral uncovertebral osteophytes and endplate osteophytes. There is ligamentum flavum hypertrophy present. There is effacement of spinal fluid ventral and posterior the spinal cord at this level and encroachment of the exiting nerve roots bilaterally within the neural foramina. There is moderate spinal stenosis at this level. There is also present on the prior exam and has not changed substantially. There are endplate reactive changes at this level which are high signal on T1.At C5-6 there is loss of disc space height, disc desiccation and endplate reactive changes of a moderate degree. There are endplate uncovertebral osteophytes present at this level which are worse in the left side when compared to the right. There is encroachment of the exiting nerve roots in the neural foramina. Overall there is no significant change compared to the prior exam.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There is redemonstration of a small syrinx (enlarged central canal) in the lower cervical spinal cord which was also present on the prior exam and has not really changed in size. Some subtle signal hyperintensity surrounding the central canal just above the C4-5 disc space level suggests possible edema surrounding the syrinx on the current exam not readily identified on the prior. Differences in scan technique confound comparison of this edematous component.2.There are multilevel degenerative changes present in the cervical spine with moderate spinal stenosis at C4-5 which are stable compared to prior exam. There is encroachment of exiting nerve roots bilaterally at C4-5 and on the left-side at C5-6. There is milder encroachment of the right-sided exiting nerve roots at C5-6 and left-sided exiting nerve roots at C3-4.