Bilateral upper extremity weakness. Additional patient history includes Chiari malformation, treated surgically in 1997. Many of the images are degraded by motion. Postoperative changes related to suboccipital craniectomy and posterior C1 arch resection is redemonstrated. The cerebellar tonsils are stable in morphology and again extend down to the level of C1, consistent with patient's Chiari I malformation. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Anterior flowing osteophytes are present throughout the cervical spine, compatible with DISH and most prominent at C3-C4 with bulging into the aerodigestive tract. There are mild vertebral body endplate degenerative changes throughout the cervical spine. Bone marrow signal is otherwise within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.Mild developmental narrowing of the spinal canal is again noted. Superimposed degenerative changes include small disc osteophyte complexes and uncovertebral hypertrophy with stenoses as described below:C2-3: Mild right neural foraminal stenosis. No significant spinal canal or left neural foraminal stenosis.C3-4: Mild bilateral neural foraminal stenosis. No significant spinal canal stenosis.C4-5: Mild to moderate right and mild left neural foraminal stenosis. No significant spinal canal stenosis.C5-6: Moderate to severe bilateral neural foraminal stenosis. No significant spinal canal stenosis.C6-7: Mild right neural foraminal stenosis. No significant spinal canal or left neural foraminal stenosis.C7-T1: Mild spinal canal narrowing and minimal bilateral neural foraminal stenosis.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. No cord signal abnormality or high-grade spinal canal stenosis at any level. Multilevel degenerative changes as detailed above are not significantly changed since prior MRI from 6/19/2012. 2. Postsurgical changes of Chiari decompression with unchanged position and configuration of the low-lying cerebellar tonsils.