Clinical question: Cervical spondylosis with radicular symptoms; any change from last MRI?. Signs and symptoms: Cervical spondylosis with radicular symptoms. Nonenhanced cervical MRI:The examination redemonstrates extensive degenerative changes of cervical spine which appears to primarily involve the disks. There is resultant mild reversal of cervical lordosis centered at C4-C5 disk level. This appearance is similar to the prior study.Foramen magnum is unremarkable.C2 -- C3 demonstrate mild bilateral (right greater than left) facet hypertrophic changes with resultant mild right neural foraminal compromise. No change since prior exam.C3 -- C4 demonstrate moderate disk disease and loss of disk height, moderate right and mild left facet hypertrophic changes and shallow broad based bulging disk. Constellation of changes results in significant right neural foraminal compromise and moderate to significant on the left as well as mild central spinal stenosis. Findings demonstrate no significant change since prior exam. C4 -- C5 demonstrate advanced disk disease with significant loss of disk height, asymmetric significant left facet hypertrophic changes. There is a broad based disk and osteophyte complex extending from right paramedian to far laterally on the left. There is interval increased size of this finding since prior exam.Above changes results in flattening and posterior displacement of the cord, moderate central spinal stenosis and significant left neural foraminal compromise.C5 -- C6 demonstrate advanced disk disease and loss of disk height and no significant facet or ligamentum flavum hypertrophy. Shallow hypertrophic spur results in partial effacement of ventral subarachnoid space and a subtle flattening deformity of the cord and mild central spinal stenosis. There is no significant change in the extent of finding since prior study.C6 -- C7 demonstrate advanced disk degeneration with significant loss of disk height. Mild right facet hypertrophy changes an unremarkable left. Ventral hypertrophic spur results in partial effacement of the ventral subarachnoid space and subtle flattening of the cord however without central spinal stenosis. Mild bilateral neural foraminal compromise. No significant change since prior exam.C7 -- T1 demonstrate mild disk disease and loss of disk height. Mild bilateral ligamentum flavum hypertrophy. No spinal stenosis or neural foraminal compromise.As was noted on prior exam there is a small syrinx of cervical cord which demonstrate no interval change since prior exam. The largest has axial dimension of the syrinx at C5 measures at 3.9 x 3.1-mm which is nearly identical to prior exam. The syrinx similar to prior exam demonstrate two small segments of expansion one centered at C5 as measured above and a smaller one at C6 -- C7 disk level similar to prior study.Nonenhanced thoracic MRI:Significant sclerosis of the thoracolumbar region is noted. There are no coronal images precise assessment of the degree or extent of the sclerosis.Severe scoliosis precludes precise assessment of the spine however within this limitation there is no evidence of central spinal stenosis at any level.The signal intensity and caliber of thoracic cord remains within normal.Scoliotic changes results in left neural foraminal compromise at T7 -- T8. There is also asymmetric left-sided facet hypertrophic changes with facet effusion T7 -- T8 level.There is significant left neural foraminal compromise at T8 -- T9 secondary to asymmetric left facet hypertrophic changes. Extensive postoperative changes of prior posterior fusion and placement of metallic hardware extends from T11 inferiorly to the lumber spine and beyond the field of the exam. There is no spinal stenosis at the visualized levels of surgery.
1.Nonenhanced MRI of the cervical spine demonstrate extensive degenerative changes of disks and to lesser degree of the posterior elements throughout the cervical spine with resultant reversal of cervical lordosis as detailed. There is progression of degenerative changes at C4 -- C5 since prior exam. Changes at this level results in central spinal stenosis and neural foraminal compromise. Degenerative changes at other levels however without significant central spinal stenosis as detailed and without significant change. Two small foci of syrinx at C5 and at C6 -- C7 disk levels remain similar to prior exam measuring maximum of 3.9 x 2.1-mm at C5 level.2.Nonenhanced MRI of thoracic spine demonstrate significant sclerosis of thoracolumbar region as was noted on prior plain radiographs. No pulmonary lesions acquired. There is no evidence of central spinal stenosis at any level. There is normal signal intensity and caliber of thoracic cord. Neural foraminal compromise in an asymmetric fashion secondary to asymmetric hypertrophic changes as result of the scoliosis as detailed per level above.