Lower extremity weakness and numbness. Assess for worsening stenosis. Cervical spine: There is reversal of the usual cervical lordosis. The vertebral bodies are preserved in height. There is mild disc height loss at C3-C4 through C6-C7 with loss of T2 signal. There is mild degenerative marrow endplate signal alteration at C6-C7. Otherwise, there is no significant vertebral bone marrow abnormality. There is no abnormal spinal cord signal. The imaged portions of the brainstem and upper thoracic spinal cord are unremarkable.C2-C3: There is mild right neural foraminal stenosis by facet arthropathy. There is no spinal canal or left neural foraminal stenosis.C3-C4: There is a disc-osteophyte complex that results in moderate spinal canal stenosis, indenting the ventral aspect of the spinal cord. In addition, uncovertebral arthropathy causes severe foraminal stenoses bilaterally.C4-C5: There is a disc-osteophyte complex that causes mild spinal canal stenosis. In addition, uncovertebral and facet arthropathy result in severe foraminal stenoses bilaterally.C5-C6: There is a disc-osteophyte complex that results in moderate-to-severe spinal canal stenosis. In addition, right greater than left uncovertebral and facet arthropathy results in severe foraminal stenoses.C6-C7: There is a disc-osteophyte complex and ligamenta flava thickening result in mild spinal canal stenosis. Left more than right uncovertebral and facet arthropathy result in severe left and moderate right foraminal stenoses bilaterally.Lumbar spine: The lumbar spine alignment is anatomic. The vertebral bodies are preserved in height. There is mild loss of disc height and T2 signal at L2-L3 through L5-S1. There is an inferior L4 endplate Schmorl node. There is abnormal contrast enhancement involving the L3-L4 facets, worse on the right, also degenerative in nature. The conus medullaris has its tip at the upper L2 level. The conus medullaris and included caudal part of the spinal cord display normal signal and morphology. There are degenerative changes involving the sacroiliac joints, as manifested by bridging osteophytes. There are multiple bilateral renal cysts.T12-L1: There is no significant disc herniation, spinal canal stenosis or foraminal stenosis.L1-L2: There is no significant spinal canal or foraminal stenosis.L2-L3: There is a disc bulge, mild ligamentum flavum thickening, and facet arthropathy, without significant spinal canal or neural foraminal stenosis.L3-L4: There is a disc bulge with a small right paracentral protrusion, ligamentum flavum thickening, and facet arthropathy, which result in moderate central and right paracentral spinal canal stenosis, as well as mild bilateral neural foraminal stenoses.L4-L5: There is a disc bulge that is eccentric to the left, which along with ligamentum flavum thickening and facet arthropathy results in mild bilateral neural foraminal stenoses, but no significant spinal canal stenosis. There is a small posterior left facet joint synovial cyst.L5-S1: There is road-based central disc bulge and bilateral facet arthropathy associated with mild foraminal stenoses bilaterally, but no significant spinal canal stenosis.
1. Degenerative cervical spondylosis at C3-4 through C5-6 with associated mild indentation of the spinal cord and extensive bilateral neural foraminal stenoses. 2. Multilevel degenerative lumbar spondylosis consists of moderate spinal canal stenosis at L3-4, as well as mild bilateral neural foraminal stenoses at L3-4 though L5-S1. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.