History of cervical meningioma status post resection. Neck and upper extremity pain. Evaluate for change in size/recurrence. Cervical Spine: There are post-surgical findings related to meningioma resection at the C2 level. There is no evidence of intraspinal mass or pathologic enhancement to suggest tumor recurrence. The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. At C2-3 there is no significant compromise to spinal canal or neural foramina. At C3-4 there is no significant compromise to spinal canal or neural foramina. At C4-5 there is new mild disc bulge and uncovertebral osteophytes causing minimal effacement of the ventral thecal sac, but no significant neural foramen compromise. At C5-6 there is mild disc bulge and posterior uncovertebral osteophytes without significant spinal canal or neural foramen stenosis. At C6-7 mild posterior uncovertebral osteophytes causes mild to moderate neuroforamen stenosis bilaterally. At C7-T1 there is no significant compromise to spinal canal or neural foramina. The vertebral artery flow voids appear to be intact.Thoracic Spine: There is severe dextroscoliosis of the thoracic spine. The thoracic vertebral bodies are appropriate in height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar Spine: There is severe levoscoliosis of the lumbar spine. There is also 14 mm of right lateral listhesis of L1 upon L2. The conus medullaris on sagittal imaging is grossly intact. At L1-2 there is mild bilateral facet hypertrophy superimposed upon the effect of right lateral listhesis result in mild spinal canal and right neural foramen stenosis. At L2-3 there is mild facet hypertrophy, mild ligamentum flavum thickening, and severe diffuse right sided disc bulge, with mild neural foramen narrowing and probable contact with the right nerve root. At L3-4 there is a disc bulge, mild ligamentum flavum thickening, and extensive bilateral facet hypertrophy causing mild central canal stenosis as well as moderate to severe right and mild left neural foramen narrowing. At L4-5 there is mild diffuse disc bulge and moderate bilateral facet hypertrophy, without significant central canal stenosis, but minimal to mild left neural foramen stenosis. At L5-S1 there is a disc bulge and moderate bilateral facet hypertrophy, without significant central canal stenosis, but mild left neural foramen stenosis.
1.No evidence of meningioma recurrence in the upper cervical spinal canal.2.Severe thoracolumbar scoliosis and right lateral listhesis of L1 on L2.3.Multilevel degenerative spondylosis of the cervical and lumbar spine, as described in the findings section.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.