 A polypoid lesion is present, but incompletely evaluated, at the right sphenoid sinus abutting the clivus, which is suspicious for a myelomatous lesion.There is enhancing lesion within the anterior vertebral body body of C5. The cervical spine is in normal alignment. The vertebral body heights are well-maintained. No abnormal cord signal is evident.Multilevel degenerative disease is present, as on prior examination with small disc osteophyte complexes, facet arthropathy, and ligamentum flavum hypertrophy with mild resultant spinal canal and neural foraminal narrowing at C4-C5, C5-C6, and C6-C7. There is mild flattening of the ventral spinal cord at C5-C6. No significant interval change since 7/2/2012.THORACIC SPINE
1. New enhancing lesions in the C5 vertebral body and L1 vertebral body consistent with myelomatous disease progression. No epidural extension or enhancing mass in the lumbar spinal canal.2. Incomplete evaluation of a small polypoid lesion at the clivus/right sphenoid sinus, which may represent a myelomatous lesion rather than just sinus mucosal disease. Dedicated imaging can be considered to better assess if clinically indicated.3. There are postoperative changes of partial corpectomy and T6-T9 fusion. Stable mild chronic compression fractures at T7 and T8 with stable associated moderate spinal canal stenosis. Small focal cord signal abnormality at this level may represent myelomalacia relate to prior compression. 4. Multilevel degenerative changes throughout the cervical, thoracic and lumbar spine, as detailed above. No significant interval change since 7/3/2012. Unchanged up to moderate spinal canal stenosis at C5-C6. Stable severe right neural foraminal stenosis at L3-4 related to disc protrusion.