Diagnosis: Lumbago. Retention of urine, unspecifiedClinical question: Evidence of cord compression?Signs and Symptoms: Lumbar back pain and urinary retention Acute cord compression protocol:The vertebral bodies are appropriate in the overall alignment and height. The spinal cord has normal signal characteristics and overall morphology. There is no compromise of the spinal cord. Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is loss of disc space height, diffuse disc bulge and bilateral uncovertebral osteophytes. There is effacement of spinal fluid ventral and posterior to the spinal cord at this level as well as encroachment of the exiting nerve roots within the neural foramina due to osteophytes and disc material more on the right side than the left. Overall there is moderate spinal stenosis present at this level.At C4-5 there is loss of disc space height, disc desiccation and disc bulge associated with bilateral uncovertebral osteophytes and bilateral encroachment of the exiting nerve roots within the neural foramina. There is partial effacement of spinal fluid ventral and posterior to the spinal cord at this level. Overall there is mild to moderate spinal stenosis at this level.At C5-6 there is loss of disc space height, diffuse disc bulge and bilateral uncovertebral osteophytes as well as posterior ligamentous hypertrophy with effacement of spinal fluid ventral and posterior to the spinal cord and bilateral encroachment of exiting nerve roots within the neural foramina. Overall there is a moderate degree of spinal stenosis at this levelAt C6-7 there is loss of disc space height and a central disc protrusion as well as disc material extending into the neural foramina bilaterally. There are uncovertebral osteophytes present on the left in the right side at this level. There is mild effacement of spinal fluid ventral to the spinal cord at this level. There is encroachment of the left-sided exiting nerve roots within the neural foramen at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.This is a limited exam specific for the exclusion of acute cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No acute cord compression is identified. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.2.The cervical spine exam demonstrates multilevel degenerative changes in the cervical spine with moderate spinal stenosis at C3-4 and C5-C6 and mild to moderate spinal stenosis at C4-5. There is bilateral neural foramen encroachment of exiting nerve roots at C4-5 and C5-6 and left-sided encroachment of exiting nerve roots at C6-7 and right-sided exiting nerve root encroachment at C3-4.