Male, 76 years old, with cervical myelopathy and spondylosis, evaluate stenosis. Reversal of the cervical lordosis is again seen slightly more so than on prior. As before, there are trace stepwise retrolistheses of C3 on C4, C4 on C5, and C5 on C6. Extensive endplate degenerative signal abnormality is demonstrated with associated chronic degenerative loss of vertebral body height, similar to prior.Foci of STIR hyperintensity are evident within the cord at C4-5 and C6. These were not evident on the prior examination, perhaps due to differences in technique. No cord swelling is seen. Elsewhere, spinal cord signal abnormality is unremarkable.C2-3: Facet arthropathy. Ligamentum flavum thickening. Posterior disc-osteophyte complex formation. Mild spinal canal stenosis without cord impingement. No foraminal narrowing. No interval changes.C3-4: Facet arthropathy. Posterior disc-osteophyte complex formation. Moderate to severe spinal canal stenosis with some ventral cord flattening, stable to slightly improved. Moderate to severe bilateral foraminal narrowing. Except as above, no changes.C4-5: Facet arthropathy. Posterior disc-osteophyte complex formation. Moderate to severe spinal canal stenosis with minimal ventral cord flattening, stable to slightly improved. Moderate to severe bilateral foraminal narrowing. Except as above, no changes. C5-6: Facet arthropathy. Ligamentum flavum thickening and posterior disc-osteophyte complex formation. Moderate to severe spinal canal stenosis with ventral cord flattening, stable to slightly improved. Moderate to severe bilateral foraminal narrowing. Except as above, no changes.C6-7: Facet arthropathy. Ligamentum flavum thickening. Posterior disc-osteophyte complex formation. Mild canal stenosis with slight cord deformation, stable to slightly improved. Moderate left and mild right foraminal narrowing. Except as above, no changes.C7-T1: Facet arthropathy. Ligamentum flavum thickening. Posterior disc-osteophyte complex formation. Moderate spinal canal stenosis without cord impingement, stable to slightly improved. Moderate left and mild right foraminal narrowing. Except as above, no changes.A pleural effusion is partially visualized on the left. A heterogeneous right thyroid nodule is also partially visualized but not significantly changed.
Multilevel advanced disc and posterior element degeneration is seen resulting in spinal canal stenosis at multiple levels. The degree of stenosis appears to be somewhat improved relative to the prior examination which could reflect differences in neck positioning. Otherwise, no significant interval change is seen.Small areas of cord signal abnormality are detected at C4-5 and C5-6. While these were not clearly evident on the prior examination, it may be that they were present but unresolvable due to differences in technique. They are favored to represent myelomalacia related to chronic impingement.A left pleural effusion is partially visualized. Unless the etiology is already known, this finding should be further evaluated with dedicated chest imaging, at the very least chest radiographs.