 There has been marked interval worsening of disk extrusion at C4-5 with mild superior and inferior migration, measuring previously 6 mm craniocaudally and now up to 23 mm (series 601 image 7), and up to 7 mm in maximal thickness compared to 4 mm previously. There is moderate to severe spinal canal stenosis with flattening of the cord at this level secondary to mass effect from the extruded disk material. There is subtle T2 cord signal at this level. There is also interval worsened height loss of the C4-5 disk space. There is mild facet arthropathy at this level, however the neural foramina at this level appear grossly intact. There is no osseous marrow edema. There is mild loss of T2 signal in essentially all cervical disks. There is straightening of the cervical spine.C2-3: Tiny right paracentral disk osteophyte complex. No spinal stenosis.C3-4: No endplate or disk degenerative changes. No spinal stenosis.C4-5: Described above.C5-6: Disk osteophyte complex and bilateral uncovertebral hypertrophy with facet arthropathy causing mild spinal canal stenosis. Moderate left and mild right neural foraminal stenosis without change.C6-7: Disk osteophyte complex and uncovertebral hypertrophy causing no significant spinal canal stenosis and mild to moderate right and moderate to severe left neural foraminal stenosis.C7-T1: No significant disk/endplate degenerative changes or spinal stenosis.
1.Marked interval worsening of disk extrusion at C4-5 compared to 8/7/2012 with moderate to severe spinal canal stenosis. There is subtle T2 cord signal abnormality. Mild interval loss of disk height at this level as well. Please see details above.2.No other significant interval changes.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.