Evaluate for spinal or foraminal stenosis. History of L4-5 spondylolisthesis, LLE radiculopathy, left thoracic flank pain Thoracic:Thoracic vertebral body heights are maintained. Alignment is maintained. No significant spinal canal or neural foraminal stenosis is seen. Bone marrow signal is benign with no suspicious lesions. There is a large cervicothoracic syrinx with the superior limit at the C1-C2 level which was seen on recent brain MRI. Inferiorly, syrinx terminates at the T10-T11 level. Syrinx measures up to 9 x 11 mm in the axial plane at the upper thoracic level where there is significant cord expansion. Prior brain MRI demonstrates findings of Chiari 1.Mild degenerative changes are seen in the thoracic spine with loss of disk height at multiple levels. Minimal disk bulges are seen at T5-T6, T6-T7, and T7-T8 without significant associated spinal canal or neural foramina stenosis.Lumbar:Five lumbar type vertebral bodies are present. Vertebral body heights are within normal limits. There is grade 1 anterolisthesis of L4 on L5. Alignment is otherwise within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position at the L1 level.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: Minimal disc bulge and dorsal annular fissure. No spinal canal or neural foraminal stenosis.L3-L4: Minimal disc bulge. No spinal canal or neural foraminal stenosis.L4-L5: There is disk desiccation with mild T2 hyperintensity in the disk and at the interspinous level. There is mild anterolisthesis, disc uncovering with left foraminal disc protrusion, ligamentum flavum thickening and moderate facet arthropathy. There is moderate left foraminal narrowing with suspected impingement of the left L4 nerve root. There is minimal spinal canal and minimal right foraminal narrowing.L5-S1: Minimal disc bulge eccentric to the right. No significant spinal canal or neural foraminal stenosis. Mild bilateral facet arthropathy.Paraspinous soft tissues are within normal limits.
1. Large cervicothoracic syrinx extending from the C1-2 level (as seen on recent brain MRI) to the T10-T11 level. Of note, recent brain brain MRI demonstrates findings of Chiari 1.2. Grade 1 anterolisthesis and facet arthropathy at L4-5. There is a left foraminal disc protrusion at this level resulting in moderate left foraminal narrowing with suspected impingement of the left L4 nerve root. 3. Mild degenerative changes in the remainder of the thoracic and lumbar spine as detailed above.