New headache, prior MRI showing Chiari malformation Low-lying cerebellar tonsils measuring 4 to 5 mm below the foramen magnum with a pointed configuration are again seen. There is mild crowding at the foramen magnum although the posterior fossa is incompletely evaluated on this cervical spine MRI. There is a small syrinx in the cervical cord extending from the C1 to the C4 levels, and measuring up to 2 mm at the mid C2 level which is similar to prior. There is minimal prominence of the central canal in the cervical cord inferior to the C4 level.The cervical vertebral bodies are appropriate in height. There is mild reversal of cervical lordosis with apex at the C3-C4 level, as before.. Bone marrow signal is benign. Multilevel degenerative changes are present as described below:Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is a disc osteophyte complex including a small subligamentous disc extrusion and uncovertebral hypertrophy particularly on the right. There is mild to moderate spinal canal stenosis, particularly the right aspect of the spinal canal which appears minimally worse in the interval. There is moderate right neural foraminal stenosis as before. Minimal left neural foraminal narrowing.C4-5: Small disc osteophyte complex and prominent left-sided uncovertebral hypertrophy. Mild to moderate spinal canal stenosis is similar to prior. There is moderate to severe left neural foraminal stenosis which is similar to prior. Right neural foramen is patent.C5-6: Small disc osteophyte complex with very mild spinal canal narrowing. Mild left neural foraminal stenosis. Right neural foramen is patent.C6-7: No significant compromise to the spinal canal or right neural foramen. Moderate left-sided facet arthropathy with mild left neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina. Right-sided facet arthropathy.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Findings compatible with a mild Chiari I malformation with a small cervical syrinx, not significantly changed since 3/25/2011. Note the posterior fossa is incompletely evaluated on this cervical spine study.2. Multilevel degenerative changes in the cervical spine which are stable to minimally worse since 2011. There is mild to moderate spinal canal stenosis at the C3-C4 level and to a milder degree at the C4-C5 and C5-C6 levels.3. Neural foraminal stenosis is worst at the right C3-C4 level and left C4-C5 levels similar to prior. Additional details as above.