 There is minimal grade 1 retrolisthesis of C3 on C4 and of C5 on C6, which appears degenerative in etiology. The cervical spine is otherwise in normal alignment, with a slight exaggeration of the normal cervical lordosis. The vertebral body heights are well-maintained. There is multilevel disc narrowing, moderate at the majority of the levels, with mineralization of the C6-C7 disc space. No worrisome focal marrow signal abnormality is appreciated. Mild endplate degenerative marrow changes are noted at C6-C7.As noted on the prior MRI of the brain, there is abnormal signal centrally within the entire visualized cervical cord. There is trace prominence of the central spinal canal just distal to the obex, with a small area of discontinuity before redemonstration of abnormal T2 hyperintensity throughout the center of the cervical cord, extending from mid C2 level into the thoracic cord. Within the cervical cord, this measures up to 7 x 5 mm at the lower C7 level.At C2-C3, there is uncovering the disc with a central disc protrusion which indents the ventral thecal sac and minimally flattens the right paramedian ventral cord. There is mild bilateral facet arthropathy without stenosis.At C3-C4, there is uncovering of the disc with a mild diffuse posterior osteophyte disk complex. There is mild central spinal canal stenosis. There is mild bilateral uncovertebral hypertrophy and ligamentum flavum thickening. There is mild to moderate right foraminal narrowing and moderate left foraminal narrowing.At C4-C5, there is a mild diffuse posterior osteophyte disk complex with mild central spinal canal stenosis and mild to moderate left foraminal narrowingAt C5-C6, there is uncovering of the disc with superimposed mild diffuse posterior osteophyte disk complex. There is right sided uncovertebral hypertrophy resulting in moderate right foraminal narrowing and mild-moderate central spinal canal stenosis.At C6-C7, there is a mild to moderate diffuse posterior osteophyte disk complex along with mild ligamentum flavum thickening and uncovertebral hypertrophy. There is overall moderate-severe right and moderate left foraminal narrowing and mild central spinal canal stenosis.At C7-T1, there is no significant disk pathology or stenosis.The appearance of the craniocervical junction is unchanged compared to the prior exam, with slight caudal extension of the a still rounded right cerebellar tonsil to 6 mm below the level of the foramen magnum with persistent moderate crowding at this level.THORACIC SPINE
1.Confirmation of cervical thoracic cord syringohydromyelia as previously suspected, extending from the mid C2 level down to the mid T8 level.2.Redemonstration of crowding at the level of the foramen magnum with mild abnormal caudal extension of the right cerebellar tonsil which could represent a very mild Chiari I malformation although the tonsil remains rounded in morphology.3.Mild-moderate cervical spondylotic changes, most conspicuous at C6-C7 where there is moderate-severe right foraminal narrowing.4.Partially visualized incidental findings, including possible right hepatic cyst, adrenal thickening with possible nodules bilaterally, and mediastinal cystic-appearing structure. Dedicated CT of the chest and abdomen recommended for further evaluation.5.Heterogeneous appearance of the thyroid gland diffusely with multiple foci of T2 hyperintensity. Correlation with thyroid function tests is recommended and thyroid ultrasound may be obtained as clinically indicated.