Neck pain, arm pain, history of C4-C7 with instrumentation. Mid back pain and numbness. CERVICAL: There are postsurgical changes of anterior cervical discectomy and fusion from C4 through C7. Interbody grafts, anterior plate, and screws can be better assessed with radiographs or CT, but demonstrate no gross evidence of displacement compared to radiograph from 2/25/2014.Spinal canal caliber is significantly improved from the C4 to C7 levels without residual spinal canal stenosis at these levels. There is a disc bulge at the C3-C4 level which contributes to mild spinal canal stenosis and appears slightly worse since prior MRI. No cord signal abnormality. Additional details described level by level as below:Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.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: Mild disc bulge and uncovertebral hypertrophy. There is mild spinal canal stenosis. There is mild right and moderate to severe left neural foraminal stenosis.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: No significant compromise to the spinal canal. There is mild right and no significant left neural foraminal stenosis.C6-7: No significant compromise to the spinal canal or right neural foramen. There is mild to moderate left neural foraminal narrowing related to facet arthropathy and uncovertebral hypertrophy.C7-T1: No significant compromise to the spinal canal. Mild to moderate left neural foraminal stenosis related to facet arthropathy. Right neural foramen is patent.THORACIC: Vertebral body heights in the thoracic spine are normal. There is a small Schmorl's node involving the inferior endplate of T8. There is mild levocurvature of the upper thoracic spine and dextrocurvature of the mid to lower thoracic spine.There are mild to moderate degenerative changes. At T2-T3 and T3-T4, there are right paracentral disc protrusions which contact the right ventral cord. At T6-T7, a left paracentral disc protrusion contacts the left ventral aspect of the cord. Small disc bulge at T7-T8 without stenosis. Small central protrusion at T8-T9 without stenosis. Scattered mild multilevel ligamentum flavum thickening and facet arthropathy also noted. There is no high-grade spinal canal stenosis at any level in the thoracic spine. No cord signal abnormality. There is also multilevel mild to moderate neural foraminal narrowing in the upper thoracic spine which is suboptimally evaluated due to motion degradation.
1. Postsurgical changes of anterior cervical fusion from C4 through C7. Previously seen spinal canal stenosis from C4-C5 to C6-C7 has resolved. There is mild spinal canal stenosis at the C3-C4 level related to disc bulge. No cord signal abnormality. Multilevel neural foraminal stenosis, particularly on the left, as detailed above.2. Mild to moderate degenerative changes in the thoracic spine without high-grade spinal canal stenosis at any level.