Clinical question: eval for stenosis, abnormality. Signs and Symptoms: bilateral upper ext weakness. Nonenhanced cervical spine MRI:Examination demonstrates extensive postoperative changes of corpectomy and anterior fusion extending from C4 through C6. The alignment of the vertebral column remains anatomical.Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative disc disease and mild bilateral ligamentum flavum hypertrophy with resultant subtle left neural foraminal compromise.C3-C4 demonstrate mild disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy, moderate left and mild right facet hypertrophic changes.Tiny focus of T2 hyperintensity within the hypertrophied left ligamentum flavum (axial T2 series 601 image 25 and sagittal T2/T2 STIR image 7) is believed to represent a tiny synovial cyst. Constellation of findings results in subtle mass effect, flattening deformity and effacement of subarachnoid space and moderate central spinal stenosis. Moderate left and mild right neural foraminal compromise is also detected. There is localized T2 signal intensity within the cord at this level representing myelopathy. No prior exams for comparison.C4-C5 demonstrate postop changes of anterior fusion, residual ventral hypertrophic spur and mild facet and ligamentum flavum hypertrophy. Constellation of changes results in mild to moderate central spinal stenosis, moderate bilateral (L>R) neural foraminal compromise.C5-C6 demonstrate anterior corpectomy with resultant expansion of thecal sac anteriorly and without evidence of central spinal stenosis. Degenerative changes however results in significant bilateral (R>L) neural foraminal compromise.C6/C7 demonstrate anterior fusion and including placement of a fixating screw, moderate disc disease and loss of disc height, moderate bilateral ligamentum flavum and mild bilateral facet hypertrophic changes. Constellation of above findings results in moderate central spinal stenosis and significant bilateral neural foraminal compromise.There is a long focus of T2/T2 STIR hyperintensity with associated decreased cord caliber extending from C4-C5 disc level inferiorly to the mid C7 level concerning for myelomalacia secondary to adenopathy.C7-T1 demonstrate minimal degenerative changes and unremarkable otherwise.Upper most visualized thoracic spine and thoracic cord to T5 level is unremarkable.
1.Postoperative changes of corpectomy at C5-C6 and anterior fusion extending from C4 through C6 as detailed.2.Degenerative changes immediately superior to the anterior fusion at C3-C4 results in moderate central spinal stenosis and with a focus of T2 hyperintensity within the cord concerning for myelopathy. 3.Mild to moderate central spinal stenosis is also noted at C4-C5 level.4.Moderate Central spinal stenosis at C6-C7secondary to degenerative disease is noted.5.Long segmental focus of T2 hyperintensity with cord volume loss at C5 and C6 levels as detailed.6.Multilevel bilateral neural foraminal compromise (some severely) as detailed per level above.7.There are no prior exams for comparison, however if such studies are available and are provided to the radiology Department an addendum to this report will be submitted after comparison.