Female, 69 years old, with history of bone cyst/hemangioma, status post cervical fusion with removal of hardware and most recently C3-C7 ACDF. Evaluate for change in cyst/meningioma. Since the prior examination, anterior instrumented cervical spine fusion has been extended and now encompasses the C3-C7 levels. An intervertebral device has been placed within the C3-4 disc space. Although the bones are not well assessed in this area due to metallic artifact, it does appear that osseous fusion has occurred at least from C4 through C7. Cervical spinal alignment is unchanged.As on the prior examinations, a well-circumscribed T2 hyperintense and fairly homogeneously enhancing lesion is redemonstrated occupying the left aspects of the fused C5, C6 and C7 vertebral bodies. There has been no significant change in the size or imaging characteristics of this lesion.A small lesion is evident within the T4 vertebral body with imaging characteristics compatible with a hemangioma, unchanged.Level specific degenerative findings are as follows:C2-3: Facet arthropathy. Mild central posterior disc-osteophyte complex formation and ligamentum flavum thickening. Mild spinal canal stenosis. No interval changes.C3-4: Facet arthropathy. Right uncovertebral hypertrophy. No significant spinal canal stenosis. Mild right foraminal narrowing. No interval changes. C4-5: Obliteration of the disc space. No spinal canal or foraminal stenosis. No interval changes.C5-6: Obliteration of the disc space. No spinal canal or foraminal stenosis. No interval changes.C6-7: Obliteration of the disc space. No spinal canal or foraminal stenosis. C7-T1: Facet arthropathy. Ligamentum flavum thickening. Mild posterior disc-osteophyte complex formation. Mild spinal canal narrowing. Moderate left foraminal narrowing.Patchy nodular lesions are seen in the right lung apex. The recent prior MRI examinations do not cover this area, but these lesions appear to have progressed when compared to a more remote chest CT from 2014.
1.Evidence of interval extension of the anterior spinal fusion which now incorporates the C3-C7 levels.2.A well circumscribed and homogeneously enhancing lesion occupying the left aspect of the C5-C7 fused vertebrae is unchanged.3.Patchy nodular opacities are evident in the right lung apex which seem to have progressed when compared to a prior chest CT from 2014. Although these findings may be infectious/inflammatory in nature, dedicated chest imaging is recommended for better assessment.