Worsening gait difficulty, evaluate for myelopathy, cord compression, etc. Craniovertebral junction appears within normal limits. There is mild exaggeration of cervical lordosis which may be positional. Minimal C5 on C6 anterolisthesis similar to prior. Alignment of the cervical spine is otherwise maintained. Vertebral body heights are normal. Bone marrow signal is benign. There is some congenital narrowing of the cervical spinal canal with superimposed degenerative changes. No abnormal cord signal is seen. Individual levels as below: C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Minimal disc osteophyte complex and ligamentum flavum thickening. Left-sided facet arthropathy. No significant spinal canal or neural foraminal stenosis. C4-5: Minimal disc osteophyte complex as well as uncovertebral hypertrophy and ligamentum flavum thickening. There is mild to moderate spinal canal stenosis with effacement of the ventral and dorsal thecal sac. No significant neural foraminal narrowing.C5-6: Minimal anterolisthesis. There is mild to moderate spinal canal stenosis with effacement of the ventral and dorsal thecal sac. There is mild bilateral neural foraminal stenosis.C6-7: Small disc osteophyte complex with effacement of the ventral thecal sac. Mild spinal canal stenosis. No significant neural foraminal narrowing.C7-T1: No significant compromise to the spinal canal or neural foramina.Enlarged and nodular left thyroid lobe again seen similar to 2008. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. There is congenital narrowing of the spinal canal with superimposed degenerative changes. There is effacement of the ventral and dorsal thecal sac resulting in mild to moderate spinal canal narrowing at C4-C5, C5-C6, and C6-C7. No evidence of frank cord compression or cord signal abnormality. 2. Mild anterolisthesis is again seen at C5-6 similar to prior CT from 2008. Flexion-extension radiographs can be considered to evaluate for instability. Exaggeration of cervical lordosis with apex at C4-C5 is also seen, which may be in part positional.