 Images of the thoracic spine are significantly limited by patient motion and are near nondiagnostic. Currently, sagittal postcontrast images through the thoracic spine are not available. Axial images of the lumbar spine are also partially nondiagnostic due to patient motion.Trace grade 1 anterolisthesis of L4 on L5 is noted which appears degenerative in nature. The spine is otherwise in normal alignment. There is mild reversal the normal cervical lordosis. The vertebral body heights are well-maintained. There is scattered multilevel disc narrowing, especially along the lower cervical spine where it is moderate in degree. There is also diffuse disc desiccation to the lumbar spine. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and grossly of normal signal. The spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level. There is no pathological enhancement.There are multilevel cervical spondylotic changes, slightly progressed since prior exam, especially along the mid to lower cervical spine. At C3-C4, there is right greater than left uncovertebral hypertrophy with a diffuse posterior osteophyte disc complex abutting and moderate-severe bilateral foraminal narrowing and mild to moderate central spinal canal stenosis. There is also a prominent central/right paracentral disc protrusion at C6-C7 which indents the ventral thecal sac and flattens the ventral cord with perhaps moderate bilateral foraminal narrowing at this level due to exuberant uncovertebral hypertrophy.At L3-L4, there is a mild disc bulge with right root of the left foraminal prominence resulting in mild to moderate right foraminal narrowing.At L4-L5, there is a mild disc bulge with tiny central annular fissure suggested as well as uncovering of the disc.At L5-S1, there is a mild disc bulge with superimposed left paracentral to foraminal disc protrusion. This impinges on the exiting left L5 nerve root with slight encroachment upon the left lateral recess and abutment of the descending left S1 nerve roots as well.There is prominent bilateral lower lumbar facet arthropathy.There is a small retropharyngeal effusion which measures up to 4 mm in greatest thickness, likely relating to posttreatment changes. There is also mild diffuse wall thickening of the esophagus with edema and ill-defined appearance. There is a small left-sided pleural effusion.
1.No MR evidence of spinal metastatic disease, although exam is significantly motion limited.2.Slight progression of cervical spondylosis with moderate-severe bilateral foraminal narrowing at C3-C4.3. Minimal degenerative grade 1 anterolisthesis of L4 on L5, with more focal disc pathology at L5-S1 where there is a left paracentral/foraminal disc protrusion impinging on the exiting left L5 nerve root and abutting the descending left S1 nerve root.