74 years Male (DOB:12/16/1941)Reason: eval radiculopathy History: significant worsening of bilateral finger paresthesias, history of C6 radiculopathy on EMG in 2006 and C6-7 disc bulge on MRI in 2006PROVIDER/ATTENDING NAME: KAMALA GULLAPALLI COTTS KAMALA GULLAPALLI COTTS The cervical vertebral bodies are appropriate in overall alignment and height. There is multilevel disc desiccation present.There is T2 hyperintense lesions present within the spinal cord without mass effect. One is centered along the right hemicord centrally at the C3 vertebral level. Another is located in the central portion of the left hemicord at the C3-4 vertebral level. These are associated with subtle focal volume loss. These were also present on the MRI from 1/14/2006.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is left-sided facet hypertrophy at this level. The facet hypertrophy has progressed since 2006.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a left paramedian disc protrusion present this level. There is left-sided facet hypertrophy present at this level. The facet hypertrophy has progressed since 2006.At C5-6 there is no significant compromise to the spinal canal or neural foramina. There are endplate osteophytes present this level associated with a central disc protrusion which has mildly progressed 2006.At C6-7 there is no significant compromise to the spinal canal. There are endplate and uncovertebral osteophytes at this level associated with disc material and only mild encroachment of the left-sided exiting nerve roots. This has minimally progressed since the previous exam.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The left vertebral artery flow void appears to be intact. The right vertebral artery flow-void is absent. This appearance is unchanged since an MRI of the brain from 11/23/2005 and an MRI of the cervical spine from 1/14/2006.
1.A couple lesions centered within the gray matter of the spinal cord at C2 and C3 subtle volume loss suggests that these may represent small foci of myelomalacia. These have not changed substantially since 2006.2.There are degenerative changes present cervical spine with mild encroachment of left-sided exiting nerve roots at C6-7. This has not significantly progressed since the previous exam from 2006.3.The right vertebral artery appears occluded. This has been the case since 2005. It is conceivable that this can suggest ischemia as an explanation for the patient's upper cervical cord lesions .