Recent falls, lower extremity weakness. Metastatic colon cancer. Partially imaged brain demonstrates T2 hyperintensity in the pons which is incompletely evaluated but may be related to chronic small vessel ischemic disease.Cervical spine:Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained aside from loss of cervical lordosis. Bone marrow signal is benign. There is T2 hyperintensity in the cervical cord bilaterally at the C3-C4 level which may represent myelomalacia with possible component of edema.Degenerative changes are seen in the cervical spine as described below:C2-3: There is a central/left paracentral disc extrusion with mild cranial and caudal extension and associated deformity of the cervical cord and moderate to severe spinal canal stenosis overall. Neural foramina are patent.C3-4: There is a disc osteophyte complex including a right paracentral disc protrusion component with associated moderate to severe spinal canal stenosis, although to a lesser degree than C2-C3. There is abnormal T2 cord signal bilaterally at this level. There is moderate to severe left neural foraminal stenosis and mild to moderate right neural foraminal stenosis related to uncovertebral hypertrophy and facet arthropathy.C4-5: Mild spinal canal and mild bilateral neural foraminal narrowing, predominantly on a developmental basis.C5-6: Mild spinal canal mild bilateral neural foraminal narrowing, predominantly on a developmental basis.C6-7: There is disc osteophyte complex including uncovertebral hypertrophy. There is mild spinal canal stenosis involving the left aspect of the spinal canal. There is moderate bilateral neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal. Mild bilateral neural foraminal narrowing. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Thoracic and lumbar spine MRI evaluation limited to sagittal sequences per cord compression protocol:There is no high-grade stenosis in the thoracic spine. Spinal canal is developmentally narrow. In the lumbar spine, there are degenerative changes with grade 1 anterolisthesis of L4 and L5. There is advanced facet arthropathy at this level with edema. Up to moderate degree of spinal canal stenosis is suspected at the L3-L4 and L4-L5 levels. There is severe neural foraminal stenosis suspected bilaterally at the L4-L5 levels and at least mild-to-moderate in degree at the L5-S1 levels. These findings can be better assessed with dedicated lumbar spine imaging.There is straightening of the cervical, thoracic, and lumbar curvature. No findings to suggest pathologic compression fractures. No large infiltrating lesions in the cervical, thoracic, or lumbar spine are appreciated. No gross evidence of epidural tumor. T12 vertebral body lesion is consistent with a hemangioma. There is a heterogeneous mass in the pelvis which is partially imaged.
1. Examination was performed per acute cord compression protocol, with additional complete cervical spine imaging. 2. There is moderate to severe spinal canal stenosis at the C2-C3 level and to a slightly lesser degree C3-C4 level. There is a prominent left paracentral disc extrusion at the left C2-C3 level which is associated with cord deformity.3. T2 hyperintensity within the cervical cord at the C3-C4 level which may represent myelomalacia with possible component of edema.4. Limited examination of the thoracic and lumbar spine per acute cord compression protocol. No findings to suggest acute cord compression in the thoracic or lumbar spine. There is moderate degree of spinal canal stenosis at the L3-L4 and L4-L5 levels which is also on a degenerative basis. There is grade 1 anterolisthesis of L4 and L5. There also appears to be severe neural foraminal stenosis at the L4-L5 levels bilaterally. Dedicated lumbar spine imaging can be considered for better evaluation of these findings as clinically indicated.