Neck pain. Right upper extremity radiculopathy, history of ACDF. Evaluate for stenosis Craniocervical junction is within normal limits. Again seen are post surgical changes of anterior cervical discectomy and fusion from C3 to C6 with solid osseous fusion again evident at C4-C5 and perhaps minimally at C3-C4 and C5-C6, which can be better assessed with CT. There is straightening of the cervical spinal curvature. Alignment of the cervical spine is otherwise maintained. Vertebral body heights are maintained.There is diffuse edema involving the bone marrow of the C6 and C7 vertebral bodies which is new. There is mild disc height loss at the C6-C7 level which is slightly worse anteriorly in the interval. No suspicious osseous lesions.There is trace prominence of the central canal at the C2 level measuring 1 to 2 mm and present on prior studies. No new cord signal abnormality.There is developmental narrowing of the cervical spinal canal with superimposed degenerative changes as described below:At C2-C3, there is minimal right-sided uncovertebral hypertrophy and mild facet arthropathy. There is no significant spinal canal stenosis. Mild bilateral foraminal narrowing.At C3-C4, there is right greater than left uncovertebral hypertrophy and mild facet arthropathy. There is moderate-severe right neural foraminal stenosis which is minimally worse since prior. There is also mild left neural foraminal stenosis. No significant spinal canal stenosis aside from developmental narrowing.At C4-C5, there is left greater than right uncovertebral hypertrophy. There is mild to moderate left and mild right foraminal narrowing. No significant spinal canal stenosis aside from development of narrowing.At C5-C6, there is right greater than left uncovertebral hypertrophy. There is severe right and mild left foraminal narrowing. There is mild spinal canal stenosis with partial effacement of the ventral and dorsal thecal sac.At C6-C7, again seen is a disc bulge and suggestion of a small left central disc extrusion with mild cranial migration, which is minimally more prominent than on prior. There is also ligamentum flavum thickening and mild facet arthropathy. There is at least moderate spinal canal stenosis with mild flattening of the cord, similar to prior. Moderate to severe right and moderate left neural foraminal stenosis is also similar to prior.At C7-T1, there is no significant spinal canal or neural foraminal stenosis.There is partial opacification of the bilateral mastoid air cells, which is again seen.
1. Compared to 8/22/2014, there is mild interval progression of degenerative changes. There is new bone marrow edema involving the C6 and C7 vertebral bodies which is favored to be on a degenerative basis. There is mild interval worsening of height loss at this level and minimal increase in prominence of a small disc extrusion at this level. There is at least moderate spinal canal stenosis at this level with mild cord flattening, but not significantly changed since prior.2. Neural foraminal stenoses are most significant at the right C3-C4, right C5-C6, and right greater than left C6-C7 levels.3. Postsurgical changes of anterior cervical fusion from C3 to C6 are again seen with solid osseous fusion at C4-C5 and to a minimal degree at C3-C4 and C5-C6, which can be better assessed with CT.4. Trace prominence of the central canal at the C2 level is again seen and of doubtful clinical significance.