Neck pain, low back pain, and paresthesias Cervical: Examination is slightly motion degraded. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is grade 1 anterolisthesis of C4 and C5 and minimal retrolisthesis of C5 on C6 and C6 on C7. Degenerative changes are seen with significant loss of disk height at the C5-C6 and C6-C7 levels. There is ankylosis of the left C3-4 facet joints. There are T2 hyperintense lesions at the T1 and T2 vertebral bodies with possible T1 hyperintensity and striations although images are motion degraded. 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 foraminal. There is prominent left-sided facet arthropathy.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: There is mild left neural foraminal stenosis related to prominent left-sided facet arthropathy. No significant compromise to the spinal canal or right neural foramina.C5-6: There is mild spinal canal narrowing related to disk osteophyte complex and ligamentum flavum thickening causing ventral and dorsal thecal sac effacement. No evidence of cord compression or cord signal abnormality. There is moderate right neural foraminal narrowing related to uncovertebral hypertrophy. There is mild left relatively greater than right facet arthropathy.C6-7: There is disk osteophyte complex and ligamentum flavum thickening resulting in partial effacement of the ventral and dorsal thecal sac and mild spinal canal stenosis. No cord compression or cord signal abnormality seen. There is uncovertebral hypertrophy with mild to moderate left and minimal right neural foraminal narrowing. Mild facet arthropathy. C7-T1: No significant compromise to the spinal canal or neural foramina. Bilateral facet arthropathy.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Lumbar: Examination is slightly motion degraded. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is evidence of lumbar levocurvature. There is grade 1 anterolisthesis of L3 on L4 and minimal anterolisthesis of L4 and L5. Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: There is a disk bulge with right paracentral disk extrusion component and resulting partial effacement of the right lateral recess. There is mild to moderate right and minimal left neural foramina narrowing. No significant central canal stenosis.L2-L3: There is loss of intravertebral disk height, mild bulge, and facet arthropathy. There is moderate right neural foraminal narrowing and minimal left neural foraminal narrowing. No significant spinal canal stenosis. L3-L4: There is loss of disk height, grade 1 anterolisthesis, as well as small bulge. There is also ligamentum flavum thickening and prominent facet arthropathy. There is resulting mild spinal canal stenosis. There is mild bilateral right worse than left neural foraminal narrowing. L4-L5: Minimal anterolisthesis and mild disk bulge. There is advanced bilateral facet arthropathy. There is mild right neural foraminal narrowing and moderate left neural foraminal stenosis. No significant spinal canal stenosis.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis. There is bilateral facet arthropathy.Paraspinous soft tissues are within normal limits. Left renal cyst incidentally noted.
1. Degenerative changes in the cervical spine with disk osteophyte complexes at C5-C6 and C6-C7 and ligamentum flavum thickening resulting in mild spinal canal stenosis at this level. No cord signal abnormality. 2. Moderate right C5-C6 neural foraminal narrowing. Additional levels of milder foraminal narrowing in the cervical spine as above.3. Multilevel degenerative changes in the lumbar spine as detailed above with mild spinal canal stenosis at L3-L4. There is degenerative spondylolisthesis at L3-L4 and to a lesser degree at L4-L5. There is multilevel neural foraminal narrowing relatively worse at the right L1-L2, right L2-L3, and left L4-L5 levels.4. Multilevel left greater than right facet arthropathy in the cervical spine as well as at multiple levels in the lumbar spine which may be contributing to patient's neck and back pain. 5. T2 hyperintense lesions at the T1 and T2 vertebral bodies with possible T1 hyperintensity are nonspecific and may represent atypical hemangiomas. Suggest comparison with priors.