62-year-old female with neck pain and pain in the left arm which radiates to the hand including all fingers. The patient has known cervical stenosis. Compare to previous MRI done 2/5/2015. Postoperative changes of Chiari decompression are again seen with preserved CSF spaces and biphasic flow at the foramen magnum. There is no discrete syrinx in the cervical spine, although there is trace prominence of the central canal as seen before. Postoperative changes are seen of multilevel laminectomies involving the lower cervical and upper thoracic spine which are unchanged. There is unchanged T2 signal abnormality along the dorsal aspect of the thoracic cord at the T1-T2 level. The cord at the T1-T2 level again abuts the dorsal dura suggesting possibility of tethering but is unchanged.There is minimal retrolisthesis of C3 on C4 and C4 on C5 which is unchanged. The vertebral body heights are maintained. There is some loss of disc height at the C3-4, C4-5 and mildly at the C5-6 levels. There are degenerative Schmorl's nodes in the C4 vertebral body which are unchanged. Otherwise there is no focal worrisome marrow signal abnormality. 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: Small disc osteophyte complex as well as mild uncovertebral hypertrophy which contributes to mild to moderate spinal canal and mild bilateral neuroforaminal stenosis. C4-5: Small disc osteophyte complex as well as mild uncovertebral and facet hypertrophy with mild ligamentum flavum thickening. There is mild to moderate spinal canal stenosis with mild to moderate left and mild right neuroforaminal stenosis.C5-6: Minimal right greater than left disc osteophyte complex, mild facet arthropathy and mild ligamentum flavum thickening without spinal canal or neuroforaminal stenosis.C6-7: Minimal disc osteophyte complex and mild ligamentum flavum thickening. No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1.Postoperative changes of Chiari decompression with preserved CSF spaces and flow across the foramen magnum.2.No discrete syrinx in the cervical spine. Unchanged trace prominence of the central canal in the upper cervical cord.3.Postoperative changes of lower cervical/upper thoracic laminectomies. Unchanged appearance of the upper thoracic cord which is dorsally positioned as before suggesting possibility of tethering. Stable T2 signal abnormality/myelomalacia along the dorsal aspect of the thoracic cord at the T1-2 level.4.Degenerative changes as described above with mild-to-moderate spinal canal stenosis at the C3-4 and C4-5 levels as well as up to mild to moderate left C4-5 neural foraminal stenosis.