Worsening left-sided weakness, falls, history of MS, evaluate for demyelinating lesions Cervical spine:Alignment of the cervical spine is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is benign. Degenerative spondylosis affects the cervical spine worst at C5-6 and C6-7. There are T2 hyperintense foci involving the cervical cord along the left lateral and dorsal aspects at the C2 level and the left lateral aspect at the C3-4, similar to 2011. There are no enhancing lesions in the cervical cord. The paravertebral soft tissues are unremarkable.C2/3: Disc osteophyte complex without spinal canal or neural foraminal stenosis.C3/4: Disc osteophyte complex without spinal canal or neural foraminal stenosisC4/5: Disc osteophyte complex with minimal cord flattening but no significant overall spinal canal or neural foraminal stenosis.C5/6: Disc osteophyte complex including central disc protrusion and ventral cord deformity. There is mild overall spinal canal stenosis at this level. No significant neural foraminal stenosis. C6/7: Disc osteophyte complex including central disc protrusion and ventral cord deformity with mild overall spinal canal stenosis. No significant neural foraminal stenosis. C7/T1: No significant spinal canal or neural foraminal stenosis.Thoracic spine:Alignment of the thoracic spine is anatomic. The vertebral body heights are grossly preserved. There is mild degenerative spondylosis of the thoracic spine. There are small Schmorl's nodes in the mid thoracic spine. There is a focus of low T1 and T2 signal involving the T10 inferior endplate, which may represent focal sclerosis, but is nonspecific. No significant spinal canal stenosis or neural foraminal narrowing at any level. There are subtle T2 hyperintense lesions involving the thoracic cord suspected along the right lateral aspect at the T6-7 level and the left dorsal aspect at the T8-9 level seen both on the sagittal STIR and axial T2 sequences. There is no enhancing lesion in the thoracic cord.
1. Unchanged T2 hyperintense foci in the cervical cord compared to 8/6/2011. There are also subtle T2 hyperintense foci which are suspected in the thoracic cord; no prior thoracic MRI is available for comparison. Findings are compatible with history of demyelinating disease. No enhancing lesions to suggest active demyelination.2. Degenerative spondylosis of the cervical spine with mild spinal canal stenosis at C5-6 and C6-7.