Male, 63 years old, with radiculopathy and neck pain, presurgical assessment. Evidence of laminectomy is seen from C4 through C6 and partially at C3 and C7, similar to prior. The typical lumbar lordosis is straightened but sagittal alignment is otherwise unremarkable.Vertebral body height and morphology are otherwise within normal limits. No pathologic marrow replacement or edema is seen. No abnormal marrow space enhancement is detected.The spinal cord is thinned and demonstrates patchy abnormal T2 signal beginning at approximately C4 and continuing down to C7. This appearance is unchanged when compared to the prior examination. No pathologic spinal cord enhancement is seen. Mild prominence of the ventral epidural venous plexus is demonstrated at C6 and C7, of doubtful significance.C2-3: Mild facet arthropathy. No significant spinal canal or foraminal stenosis. No interval changes. C3-4: Facet arthropathy, right worse than left. Mild posterior disc-osteophyte complex formation. Posterior spinal canal decompression. Moderate left and mild right foraminal narrowing. No significant interval changes. C4-5: Facet arthropathy. Posterior disc-osteophyte complex formation asymmetric to the right foraminal zone. Posterior spinal canal decompression. Severe right foraminal narrowing, not significantly changed. C5-6: Facet arthropathy. Posterior disc-osteophyte complex formation. Posterior spinal canal decompression. Moderate left and mild right foraminal narrowing. No interval changes.C6-7: Facet arthropathy. Posterior disc-osteophyte complex formation asymmetric to the right. Posterior spinal canal decompression. Severe right and moderate left foraminal narrowing, not significantly changed. C7-T1: Facet arthropathy. No significant disc degeneration or spinal canal stenosis. At most, minimal left foraminal narrowing. No interval changes.
1.Evidence of prior posterior spinal canal decompression from C3 through C7. Thinning and patchy T2 signal abnormality of the spinal cord through this region likely represents myelomalacia from prior impingement.2.Multilevel disc and posterior element degeneration is seen. Although there are no areas of high-grade spinal canal stenosis, severe foraminal narrowing is suspected on the right at C4-5 and on the right at C6-7.