History of C2-C4 ACDF presenting with C6 radiculopathy. There are postsurgical findings related to C3 through C5 anterior spinal fusion. There is diffuse loss of cervical lordosis. There is multilevel degenerative spondylosis. In particular, at C2-C3, there is a slight disc bulge and mild uncovertebral joint hypertrophy, with mild left neural foraminal stenosis, but no significant spinal canal or right neural foraminal stenosis. At C3-C4, there is considerable spinal canal narrowing due to the altered alignment of the vertebral bodies and what may be an underlying congenitally narrow spinal canal, but no disc-osteophyte complex is present. At C4-C5, facet hypertrophy results in moderate left and mild right neural foraminal stenosis and the altered alignment of the vertebral bodies and what may be an underlying congenitally narrow spinal canal results in considerable spinal canal stenosis. At C5-C6, a disc bulge asymmetric to the left and uncovertebral joint hypertrophy result in severe left and mild right neural foraminal stenosis, as well as compression of the spinal cord. At C6-C7, a disc bulge asymmetric to the left and uncovertebral joint hypertrophy results in severe left and mild right neural foraminal stenosis, as well as severe spinal canal stenosis. There is mild prominence of the central canal at the C7 and T1 levels. The vertebral body heights are intact. The vertebral bone marrow signal is unremarkable, aside from the postoperative alterations. The paraspinal soft tissues are unremarkable.
1. Postoperative changes from C3 to C5 anterior spinal fusion with spondylitic changes at these level results in considerable spinal canal stenosis at these levels, with contribution from altered alignment and what represent an underlying congenitally narrow spinal canal.2. Spondylitic changes also result in severe spinal canal and neural foraminal stenoses on the left at the C5-6 and C6-7 levels, as well as a mild syrinx inferior to these levels.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.