Back pain and fever. Lower extremity weakness. History of lung transplant. CERVICAL:There is sagittal straightening, which may reflect patient positioning. Vertebral body heights are preserved. There are fat-containing marrow lesions, most compatible with hemangiomas. There is mild multilevel disc desiccation in addition to height loss at C6-C7. Degenerative endplate changes are seen, most pronounced at C4-C5, where there is mild spinal canal stenosis. Even milder canal stenosis is present at the levels C3-C4 through C6-C7. The spinal cord shows normal signal. There is moderate-to-severe bilateral C3-C4 and bilateral C4-C5 neural foraminal stenosis with mild or mild-to-moderate bilateral C5-C6 and C6-C7 neural foraminal stenoses.THORACIC:Sagittal alignment is anatomic. The vertebral bodies are preserved in height and there is no suspicious marrow signal abnormality. There is mild upper thoracic disc desiccation and height loss. There is also mild right facet proliferative change at T10-T11 indenting the thecal sac. There is no significant disc protrusion. The spinal canal is preserved and the spinal cord is normal signal and morphology. Bilateral pleural effusion/thickening and pulmonary opacification are better assessed on the companion CT scan.LUMBAR:Sagittal alignment is anatomic. The vertebral bodies are preserved in height and there is no suspicious marrow signal abnormality. There is disc desiccation at L2-L3 through L4-L5 associated with mild disc height loss and a small bulge at L2-L3 and minimal height loss without significant bulge at the other 2 levels. Otherwise, the thecal sac is preserved. The conus medullaris tip is at L1-L2 level. The conus shows normal shape and signal.T12-L1 and L1-L2: No significant disc herniation. No spinal canal or neuroforaminal stenosis.L2-L3: There is a left paracentral disc extrusion which posteriorly displaces the traversing left L3 nerve root and causes mild left neural foraminal stenosis. There is mild-to-moderate facet arthropathy but no significant central spinal canal stenosis.L3-L4: There is a small disc bulge that is eccentric to the left along with bilateral facet arthropathy resulting in mild bilateral neural foraminal stenosis but no significant spinal canal stenosis.L4-L5: Severe right and mild-to-moderate left facet arthropathy along with a small disc bulge causing no significant central spinal canal stenosis and only mild left subarticular recess stenosis. There is also mild bilateral foraminal stenosis.L5-S1: There is no significant spinal canal or neural foraminal stenosis.
1.Multilevel cervical spondylosis causes mild spinal canal stenosis at C4-C5 and multilevel neural foraminal stenoses as described above.2.Thoracic spine shows minimal multilevel spondylosis but no spinal canal or neuroforaminal stenosis. 3.Relatively mild multilevel degenerative disease in the lumbar spine is most pronounced at L2-L3, where there is a left paracentral disc extrusion posteriorly displacing the traversing left L3 nerve root. Please correlate with left L3 radiculopathy.4.There is no abnormal spinal cord signal or compression. There is also no gross signs of spinal infection.5.Bilateral pleural effusion/thickening and pulmonary opacification are better assessed on the companion CT scan.