Lower extremity weakness bilaterally There is interval increase in destructive changes at the C6-C7 disc level including the adjacent C6 and C7 vertebral bodies with loss of vertebral body height. T2 hyperintensity involving the disc space and bone marrow compatible with edema is stable to minimally increased in the interval. There is a dorsally projecting osteophyte/osseous retropulsion which results in flattening of the cord which is worse since prior. There is also increased T2 hyperintensity in the cord compatible with edema. Prevertebral edema is improved since prior. Moderate spinal canal stenosis at the C2-C3 C3-C4, C4-C5, and C5-C6 levels is similar to prior. There is T2 hyperintensity in the ventral epidural space extending from C5 to C7 which is favored to represent engorged epidural venous plexus.Diffuse low T1 and T2 bone marrow signal may be related to renal osteodystrophy and/or chronic anemia. Vertebral body heights and alignment in the thoracic and lumbar spine are maintained. Small Schmorl's nodes are incidentally noted. No significant spinal canal stenosis in the thoracolumbar spine is appreciated.
Examination is limited to sequences per cord compression protocol. Compared to 12/29/2014, there has been worsening of endplate destructive changes at the C6-C7 level, worsening vertebral body height loss, stable to slight worsening of disc/bone marrow edema at this level, and worsening of osseous retropulsion, which now results in severe spinal canal stenosis. There is edema in the cord at this level which is new since prior. Possibilities of this destructive process include dialysis-related spondyloarthropathy and chronic discitis-osteomyelitis. Epidural tissue in the C5-C6 level is favored to represent engorged venous plexus. Please refer to separate cervical spine MRI for additional findings.No significant spinal canal stenosis in the thoracic or lumbar spine.