 There is mild retrolisthesis of C3 relative to C4 and C4 relative to C5 unchanged. There is multilevel degenerative marrow signal abnormality. Bone marrow signal is heterogenous without suspicious lesions. Vertebral body heights are preserved. The cervical cord is again severely compressed at C3-4 with severe reduction in cord volume and abnormal increased T2 signal consistent with myelomalacia, overall appearing similar to the prior study. There is severe multilevel loss of disk height. Additional level specific findings are as follows:C2-C3: Moderate right facet hypertrophy results in moderate right neuroforaminal stenosis. No significant left neural foraminal or spinal canal narrowing.C3-C4: Large posterior disk osteophyte complex and facet and uncovertebral joint hypertrophy results in severe spinal stenosis with flattening of the cord and abnormal cord signal consistent with myelomalacia. There is moderate right and moderate to severe left neuroforaminal narrowing.C4-C5: Posterior disk osteophyte complex results in moderate spinal stenosis and mild cord deformity. Again seen is severe bilateral neuroforaminal stenosis.C5-C6: Posterior disk osteophyte complex asymmetric towards the right without significant central canal stenosis. There is severe right and moderate left neuroforaminal narrowing.C6-C7: Mild posterior disk osteophyte complex without significant central stenosis. Moderate bilateral neuroforaminal narrowing.C7-T1: Mild posterior disk osteophyte complex without significant central canal stenosis. Moderate left and mild right neuroforaminal narrowing.Mild degenerative changes affect the upper thoracic spine appearing similar to the prior study. Again noted is a hemangioma of the T4 vertebral body. The craniocervical junction and paraspinal soft tissues are unremarkable.
Chronic severe spinal stenosis at C3-C4 and moderate stenosis at C4-C5 with myelomalacia. Findings are not significantly changed since 2012. Moderate to severe neural foraminal stenosis at multiple levels as detailed above.