 CERVICAL SPINE:An ACDF involving the C3/4, C4/5, C5/6 and C6/7 levels obscures full evaluation of the cervical spine at these levels. Significant motion also limits full evaluation at all cervical levels. Within these limitations:The cervical spine is straightened. The marrow signal is benign. The cervical cord is normal in signal. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.C1/2: Normal atlantodental interval.C2/3: There is 2 mm of Grade 1 anterolisthesis of C2 on C3. No significant spinal canal stenosis or neuroforaminal narrowing.C3/4: Mild left posterior osteophyte formation and residual disc material in the far lateral recess causes encroachment on the exiting nerve root. No significant spinal canal stenosis.C4/5: No significant spinal canal stenosis or neuroforaminal narrowing.C5/6: No significant spinal canal stenosis or neuroforaminal narrowing.C6/7: Facet hypertrophy. No significant spinal canal stenosis or neuroforaminal narrowing.C7/T1: No significant spinal canal stenosis or neuroforaminal narrowing.THORACIC SPINE:There is thoracic kyphotic curve. There is multilevel disc dessication and disc height loss. The vertebral body of T10 is collapsed with approximately 50% loss of height which is new compared to the CT exam from 12/27/14. There is increased signal on STIR indicating a subacute fracture. There is minimal restropulsion The remaining thoracic vertebral body heights and disc spaces are maintained. Marrow signal intensity is benign throughout. The spinal cord has a smooth contour and is without focal atrophy, edema, or myelomalacia. There are no masses. T1/2 Small broad based disc bulge. No significant spinal canal stenosis or neuroforaminal narrowing.T2/3 Small broad based disc bulge. No significant spinal canal stenosis or neuroforaminal narrowing.T3/4 No significant spinal canal stenosis or neuroforaminal narrowing. T4/5 No significant spinal canal stenosis or neuroforaminal narrowing.T5/6 Small left paracentral disc protrusion. No significant spinal canal stenosis or neuroforaminal narrowing.T6/7 Small left paracentral disc protrusion. No significant spinal canal stenosis or neuroforaminal narrowing.T7/8 Small left paracentral disc protrusion. No significant spinal canal stenosis or neuroforaminal narrowing. T8/9 Small right paracentral disc protrusion. Mild to moderate right neuroforaminal narrowing. No significant spinal canal stenosis. T9/10 Mild disc bulge. The compression fracture of T10 demonstrates mild retropulsion of fracture fragments which causes mild spinal canal narrowing. This is more likely a benign compression fracture. No significant neuroforaminal narrowing. T10/11 No significant spinal canal stenosis or neuroforaminal narrowing. T11/12 Small right paracentral disk protrusion. No significant spinal canal stenosis or neuroforaminal narrowing. T12/L1 demonstrates no significant disc bulge or cord encroachment. Lumbar spine:Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. There is a right laminotomy defect at L4-5.T12/L1: No significant spinal canal stenosis or neuroforaminal narrowing noted on sagittal images. L1/2: No significant spinal canal stenosis or neuroforaminal narrowing. L2/3: Disk dessication and loss of disc height. Small left paracentral disc herniation with resultant mild left neuroforaminal narrowing. No significant spinal canal stenosis. L3/4: Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal stenosis of neuroforaminal narrowing. L4/5: There is loss of disc space height with endplate reactive change, mild broad based disc bulge, facet hypertrophy, and ligamentum flavum thickening which causes encroachment of the exiting nerve roots right more than left. There is no significant spinal canal stenosis at this level. There is a right laminotomy defect at this level.L5/S1: Moderate facet hypertrophy and ligamentum flavum thickening. No significant spinal canal stenosis. Mild bilateral neuroforaminal narrowing.SI Joints: No significant abnormalities.
1.Artifact from motion and a ACDF from C3-C7 limits evaluation of the cervical spine. Within these limitations, there are multilevel degenerative changes and grade 1 anterolisthesis of C2 on C3 but no cord compression.2.Multilevel degenerative changes of the thoracic spine with a compression fracture of the T10 vertebral body with approximately 50% height loss,significantly progressed compared to the CT exam from 12/27/2014. Morphologic features of this compression fracture suggest a benign etiology.3.Multi-level degenerative changes of the lumbar spine most severe at L4/5 but no significant spinal canal narrowing as described above.