Reason: s/p C2-T4 fusion and C3-C7 laminectomy c/o right arm weakness r/o C5 palsy/nerve compression History: acute right arm weakness Interval postsurgical changes of laminectomy from C3 to C7 are seen. Posterior spinal fusion hardware is seen extending from the C2 to the T4 levels. Hardware can be better assessed with CT. Spinal canal is well decompressed. Susceptibility artifact limits evaluation however no obvious cord signal abnormality is appreciated. There is ossification of the posterior longitudinal ligament from C4 to C5 as seen previously. Diffuse multifocal bone marrow heterogeneity is noted related to diffuse osseous metastatic disease.Vertebral body heights and alignment are maintained. At C3-C4 there is severe left and moderate right neural foraminal stenosis. At C4-C5 there is severe left and moderate right neural foraminal stenosis. At C5-C6 there is moderate left and mild right neural foraminal stenosis. At C6-C7 there is moderate to severe right and moderate left neural foraminal stenosis. At C7-T1 there is mild to moderate right and mild left neural foraminal stenosis. These findings are much better assessed on prior CT.Expected postsurgical changes include small fluid collection in the midline posterior paraspinous soft tissues.
Interval postsurgical changes of C3 to C7 laminectomy. Spinal canal is well decompressed. Posterior spinal fusion hardware is seen from C2 to T4. Hardware can be better assessed with CT. There is multilevel neural foraminal stenosis, including the right C4-C5 level, and was better assessed on prior CT from 12/22/2015. No obvious hematoma, cord signal abnormality, or evidence of nerve root avulsion within the limits of susceptibility artifact from the hardware. 