Reason: Patient with likely neurogenic claudication History: bilateral leg pain Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology.There appears to be thickening of the posterior longitudinal ligament from C2-3 to see 56At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes present at this level associated with a disk bulge and with only some mild narrowing of the neural foramina.At C4-5 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes present at this level with only some mild narrowing of the neural foramina.At C5-6 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes present at this level associated with a disk bulge and with only some mild narrowing of the neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.MRI thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. At T8-9 there is loss of disk space height associated with a diffuse disk bulge posterior ligamentous hypertrophy and T2 signal hyperintensity within the T8 and T9 vertebral bodies. There is a resultant effacement of spinal fluid surrounding the spinal cord at this level and flattening of the spinal cord. Overall there is a severe degree of spinal stenosis present. The spinal cord signal is abnormal at this level. There is also bilateral neural foramen encroachment at this level with encroachment of the exiting nerve roots.At T7-T8 there is a disk bulge present without significant compromise of spinal canal or neural foraminaLumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is some accumulation of fat within the distal lumbar spinal canal suggestive of an element of epidural lipomatosis.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a disk bulge present at this level. There is mild facet hypertrophy at this level. There is mild disk desiccation at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is a disk bulge present at this level. There is mild to moderate facet hypertrophy at this level. There is mild disk desiccation at this level.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a disk bulge present at this level. There is mild disk desiccation at this level. At L2-3 there is no significant compromise to spinal canal or neural foramina. There is a cystic lesion present along the right posterolateral aspect of the spinal canal at this level associated with the ligamentum flavum but protruding into the spinal canal. It does not appear to cause significant compromise to the spinal canal.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Severe spinal stenosis at T8-9 associated with cord signal abnormality. There is associated encroachment of exiting nerve roots. Etiology appears to be degenerative in nature.2.Findings suggest some ossification of the posterior longitudinal ligament and degenerative changes in the cervical spine without significant compromise of spinal canal or neural foramina.3.There are degenerative changes present in the lumbar spine is also mild distal lumbar spinal canal epidural lipomatosis. There is no significant compromise to the lumbar spinal canal exiting nerve roots as a result of the degenerative changes. The effect of the epidural lipomatosis is best assessed clinically.4.Findings were discussed with Dr Pac at 9:45 am5.There is a cystic lesion protruding into the spinal canal at the L2-3 level which could represent either a ligamentum flavum cyst or synovial cyst.