Clinical question: Rule out cord compression. Signs and symptoms: Back pain, UMN signs. Pre- and post enhanced cervical MRI:Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes and unremarkable otherwise.C3-C4 demonstrate mild disc desiccation, minimal asymmetric moderate right facet hypertrophic changes and mild facet disease on the left. There is resultant significant right and mild left neural foraminal compromise and no central spinal stenosis.C4-C5 demonstrate mild disc disease and loss of disc height, moderate (L>R) facet hypertrophic changes and mild broad-based bulging disc. Constellation of findings results in significant (L>R) neural foraminal compromise and no central spinal stenosis. There is minute anterolisthesis at this level.C5-C6 demonstrate advanced disc disease and loss of disc height, mild bilateral facet hypertrophic changes. Constellation of changes results in significant right and moderate left neural foraminal compromise and no central spinal stenosis.C6-C7 demonstrate moderate disc disease and loss of disc height, mild bulging disc and mild bilateral facet disease. Constellation of findings results in moderate to significant (R>L) neural foraminal compromise and no central spinal stenosis.C7-T1 demonstrates moderate disc disease and loss of disc height, shallow broad-based bulging disc and no significant facet or ligamentum flavum hypertrophy. Mild bilateral (R>L)neural foraminal compromise and no central spinal stenosis.Post enhanced images demonstrate only expected enhancement of degenerative changes of the spine and unremarkable otherwise.Pre and post enhanced thoracic MRI:Examination demonstrates normal signal intensity and alignment of vertebral column.There is normal signal intensity and caliber of the thoracic cord.There is no evidence of spinal canal or neural foraminal compromise at any level.There is no detectable abnormal enhancement the vertebral column, thoracic cord, leptomeninges or the paraspinal soft tissues. No its any x-ray for any active inflammation but not usually present in the lateralPre and post enhanced lumbar MRI:The signal intensity of vertebral column demonstrate changes related to degenerative disease and unremarkable otherwise.The alignment of vertebral column remains anatomical.T12-L1 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.L1-L2 demonstrate moderate disc disease and loss of disc height and mild hypertrophic changes of posterior elements. There is a left lateral and far lateral broad-based disc protrusion at this level with resultant moderate left lateral recess compromise and mild central spinal stenosis. Bilateral neural foraminal remain patent.L2-L3 demonstrate mild to moderate disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy and shallow broad-based bulging disc. Constellation of findings results in moderate central spinal stenosis, moderate right and mild left neural foraminal compromise.L3-L4 demonstrate moderate disc disease and loss of disc height, diffuse bulging disc, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. Constellation of changes results in significant central spinal stenosis and severe bilateral neural foraminal compromise.L4-L5 demonstrate moderate disc disease and loss of disc height, shallow broad-based bulging disc, mild bilateral facet hypertrophy and suggestion of a prior left-sided laminectomy with focal expansion of thecal sac. Degenerative changes at this level results in mild central spinal stenosis and moderate to severe bilateral neural foraminal compromise (R>L).L5-S1 demonstrate moderate disc disease and loss of disc height, mild bilateral facet hypertrophy. There is no spinal stenosis and no significant neural foraminal compromise.No detectable. Spinal soft tissue abnormalities.Post enhanced images demonstrate expected enhancement of hypertrophic changes of posterior elements and unremarkable otherwise.
1.Pre and post enhanced cervical MRI demonstrated normal signal intensity and caliber of cervical cord without abnormal enhancement, no evidence of a spinal stenosis however there are multilevel neural foraminal compromise (mostly significantly) as detailed. Level above.2.Pre- and post enhanced MRI of thoracic spine is unremarkable.3.Pre and post enhanced lumbar MRI demonstrate degenerative changes of the lumbar spine with resultant significant central spinal stenosis at L3-L4 level and to a lesser degree at L1-L2 and L2-L3 levels as detailed. Left sided disc protrusion at the L1-L2 with resultant left lateral recess compromise. Multilevel neural foraminal compromise as detailed per level above. Unremarkable post enhanced images other than expected enhancement of hypertrophic changes. Normal signal intensity of the conus and the cauda equina without abnormal enhancement.