Clinical question: History of cervical myelomalacia that was operated on in the past. Now with right-sided weakness. Signs and symptoms: Right-sided weakness. Nonenhanced cervical MRI:Examination demonstrate small noncontiguous foci of T2 hyperintensity in the cervical cord similar to prior exam.A small focus in the right paramedian anterior cord extends from C3-C4 disk space level inferiorly to C5 similar to prior study. A slightly larger focus of encephalomalacia in the lateral aspect of the cord bilaterally at C5 with distinct decreased cord caliber also remains identical to prior exam.Postoperative changes of anterior corpectomy and fusion remains similar to prior study. Postoperative changes extends from C3 to C7 with evidence of metallic plate placement anteriorly and fixating screws.There is mild central spinous stenosis at the surgical levels without appreciable change since prior exam.Neural foraminal compromise at C3 -- C4 bilaterally, C4 -- C5 bilaterally, C5 -- C6 bilaterally and C6 -- C7 on the left.
1.No convincing evidence of any new foci of cord signal abnormality since prior exam.2.Stable noncontiguous foci of myelomalacia of the cervical cord as detailed.3.Stable extensive postoperative changes of multilevel anterior corpectomy and fusion extending from C3 to C7.4.Mild decrease caliber of the spinal canal at the surgical levels similar to prior exam.5.Multilevel neural foraminal compromise without appreciable interval change since prior study.