Patient with progressive walking problems, evaluate for spinal stenosis. Cervical spine:There is minimal retrolisthesis of C3-C4, C4-C5, and C5-C6 levels, similar to prior exam. Otherwise the alignment is maintained. There is minimal loss of height associated with C4, C5, and C6 vertebral bodies, minimally progressed as compared to prior exam. No cord signal abnormalities are identified. Paraspinal soft tissues are unremarkable.Multilevel degenerative changes, individual levels as below:C2-C3: No significant spinal canal or neural foraminal stenosis.C3-C4: Posterior disc osteophyte complex, facet joint arthropathy and ligamentum flavum thickening results in mild spinal canal stenosis, moderate to severe left neural foraminal stenosis and mild right neural foraminal stenosis.C4-C5: Disc osteophyte complex including uncovertebral hypertrophy results in moderate spinal canal stenosis and moderate to severe bilateral neural foraminal narrowing, left worse than the right.C5-C6: Posterior disc osteophyte complex and uncovertebral hypertrophy results in moderate spinal canal stenosis and moderate bilateral neural foraminal narrowing, worse on the rightC6-C7: Uncovertebral hypertrophy results in mild left neural foraminal narrowing with no significant spinal canal or right neural foraminal stenosis.C7-T1: No significant spinal canal or neural foraminal narrowing.Lumbar spine:For numbering purposes, there are total of 5 lumbar type vertebral bodies. There is grade 1 anterolisthesis of L3 on L4 and L5 on S1. Otherwise the alignment is anatomic. Multilevel Schmorl nodes are noted, with no destructive osseous lesions. There is multilevel disc desiccation and disc height loss, most prominent at the L4-L5 and L5-S1 levels. No signal abnormalities are noted within the spinal cord. Visualized paraspinous soft tissues are unremarkable. Conus medullaris is normal in appearance and terminates at an appropriate level. Multilevel degenerative changes are described level by level, as below:T12-L1: No significant spinal canal or neural foraminal stenosis.L1-L2: No significant spinal canal or neural foraminal stenosis.L2-L3: Diffuse disc bulge and facet joint arthropathy results in mild left neural foraminal stenosis, with no significant spinal canal or right neural foraminal stenosis.L3-L4: Diffuse disc bulge and facet joint arthropathy results in moderate left and mild-to-moderate right neural foraminal stenosis, with partial effacement of the lateral recesses, but no significant central canal stenosis. There is suggestion of prior right laminectomy. L4-5: Disc bulge eccentric to the right resulting in mild to moderate right and moderate left neural foraminal stenosis. No significant spinal canal stenosis.L5-S1: Facet joint arthropathy results in mild to moderate bilateral neural foraminal stenosis, with no significant spinal canal stenosis.
1.Multilevel degenerative changes in the cervical spine are again seen. There is up to moderate spinal canal stenosis at the C4-C5 and C5-C6 levels which is not significantly changed since 7/15/2014. No cord signal abnormality.2.Multilevel degenerative changes in the lumbar spine without significant spinal canal stenosis at any level. Neural foraminal stenoses as detailed above, which are similar to prior study dated 10/31/2013.