Clinical question: Evaluate for lesions in the cervical, thoracic and lumbar spine. Signs and symptoms: Two year progressive gait difficulty, EMG with thoracic and lumbar radiculopathies. Family history of multiple sclerosis and limb girdle dystrophic. Pre-and post-enhanced cervical MRI:The signal intensity of vertebral column demonstrate minimal changes secondary to degenerative disease and unremarkable otherwise.The alignment of vertebral column is anatomical.There is no detectable morphological or signal intensity abnormality of the cervical cord.Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate mild degenerative changes with resultant mild to moderate left neural foramina compromise and unremarkable otherwise.C4 -- C5 demonstrate mild degenerative changes of disk and posterior elements (left greater than right). There is moderate to significant left and mild to moderate right neural foraminal compromise and mild central spinal stenosis.C5 -- C6 demonstrate moderate disk disease, loss of disk height and mild bilateral facet and ligamentum flavum hypertrophy. There is bilateral uncovertebral hypertrophy and disk -- osteophyte along the ventral aspect of the canal with resultant effacement of subarachnoid space, flattening and posterior displacement of the cord and moderate central spinal stenosis as well as significant bilateral neural foraminal compromise. C6 -- C7 demonstrate moderate disk disease and loss of disk height and mild bilateral facet and ligamentum flavum degenerative changes. There is no central spinal stenosis however moderate to significant bilateral neural foraminal compromise is present.C7 -- T1 is unremarkable.Post enhanced images demonstrate no abnormal enhancement of the cord or the meninges.Pre-and post enhanced thoracic MRI:There is normal signal intensity and anatomical alignment the vertebral column however mild exaggeration of process of the thoracic spine is noted.There is normal signal intensity and caliber of thoracic cord and without findings to suggest demyelinating disease.At T2 -- T3 there is mild degenerative disk disease and loss of disk height and moderate bilateral ligamentum flavum hypertrophy and facet disease. There is resultant minimal grade 1 anterolisthesis and mild central spinal stenosis without neural foraminal compromise.Mild to moderate degenerative disk disease and multiple Schmorl's nodes of the endplates are identified in mid to lower thoracic spine however with out evidence of central spinal stenoses at any level and no significant neural foraminal compromise present.Post enhanced images demonstrate enhancement of multiple Schmorl's nodes and unremarkable the spine. There is no detectable abnormal enhancement of the cord or the leptomeninges.Pre-and post enhanced lumbar MRI:There is normal anatomical alignment the vertebral column.There is normal signal intensity and caliber of conus and the cauda equina. T12 -- L1 is unremarkable.L1 -- L2 is unremarkable.L2 -- L3 demonstrate mild degenerative disk disease and mild to moderate ligamentum flavum hypertrophy and mild facet disease. No spinal stenosis or neural foraminal compromise. A Schmorl's node along the inferior endplate of L3 is noted.L3 -- L4 demonstrate mild disk disease and loss of disk height, shallow broad-based bulging disk, moderate bilateral ligamentum flavum hypertrophy and mild facet degenerative changes. There is mild mass effect on the thecal sac by a bulging disk and ligamentum flavum hypertrophy however no convincing evidence of central spinal stenosis and the AP diameter of the thecal sac measures at 10 mm. Moderate left neural foraminal compromise is present.L4 -- L5 demonstrate moderate disk disease and loss of disk height, moderate bilateral ligamentum flavum and right facet hypertrophy changes and mild left facet degenerative changes. No central spinal stenosis and moderate to severe right neural foraminal compromise which is secondary to asymmetric right facet hypertrophy.L5 -- S1 demonstrate moderate disk disease and loss of disk height moderate bilateral ligamentum flavum hypertrophy and mild bilateral facet hypertrophy changes. No spinal stenosis is noted. Mild to moderate right neural foraminal compromise is however present.Post enhanced images demonstrate no abnormal enhancement of the lower most visualized cord, conus or cauda equina. There is however subtle expected enhancement of hypertrophic changes of posterior elements present.
1.Pre-and post enhanced MRI of cervical spine demonstrate no detectable signal abnormality or enhancement cord. Degenerative changes of cervical spine with resultant mild central spinal stenosis at C4 -- C5 and moderate central spinal stenosis at C6 -- C7. There is significant bilateral neural foraminal compromise at C5 -- C6, moderate to significant bilateral neural foraminal compromise at C6 -- C7 levels. Please see detailed report level above. 2.Pre-and post enhanced MRI of thoracic spine demonstrate normal signal intensity of the cord and without abnormal enhancement. At T2 -- T3 there is minimal retrolisthesis secondary to degenerative disease with resultant mild central spinal stenosis without neural foraminal compromise. No spinal stenosis or neuroforaminal compromise at any other level. Multiple levels of mid to lower thoracic spine degenerative disk disease and multiple Schmorl's nodes along the endplates with expected enhancement are noted.3.Pre-and post enhanced MRI of lumbar spine demonstrate no abnormal signal intensity or enhancement of the conus or cauda equina. There is no significant spinal stenosis at any level. Multilevel neural foraminal compromise (some significantly) are present as mentioned above. Please review detailed report per level above.4.