Male, 65 years old, with deltoid weakness, status post C2-T4 fusion, assess for changes that could account for right-sided C5 palsy. Evidence of interval bilateral instrumented fusion is seen from C2 through T4. Laminectomy has also been performed from C3 down to C7 and perhaps partially at T1. The spinal canal is well decompressed through the laminectomy region with relief previously seen multilevel stenoses.Redemonstrated is a severe compression deformity of C7 with complete loss of vertebral body height. The C6 vertebral body remains anteriorly subluxed relative to C7 and T1, similar to the prior exam.Marrow signal characteristics are slightly heterogeneous. In addition, there are small focal areas of STIR hyperintensity within the right lateral mass of C1, similar to prior. No evidence of marrow edema is seen.Within the limitations of artifactual image degradation, the cervical spinal cord shows normal signal intensity and morphology. No obvious focal lesions are identified.C2-3: Minimal posterior disc-osteophyte complex formation. Questionable mild left foraminal narrowing but this could also be artifactual and related to instrumentation. C3-4: Posterior disc-osteophyte complex formation with central focality. Posterior decompression of the spinal canal. No spinal canal stenosis. Moderate bilateral foraminal narrowing. C4-5: Mild posterior disc-osteophyte complex formation. Posterior spinal canal decompression. No spinal canal stenosis. Moderate right foraminal narrowing. The left neural foramen is not adequately visualized. C5-6: Minimal posterior disc-osteophyte complex formation. Posterior spinal canal decompression. No spinal canal stenosis. Possible mild left foraminal narrowing.C6-7: Spondylolisthesis along with deformity from the C7 compression cause effacement of the ventral thecal sac. Posterior spinal canal decompression. No significant spinal canal stenosis. Mild left foraminal narrowing.C7-T1: Posterior disc-osteophyte complex formation. Posterior spinal canal decompression. No significant spinal canal stenosis. Mild left foraminal narrowing.
1.Postoperative findings are seen compatible with posterior instrumented fusion extending from C2 down to T4. Also noted is laminectomy from C3 through C7 with decompression of multilevel stenosis seen previously.2.Severe compression deformity of C7 with associated anterolisthesis of C6, unchanged.3.No significant change in degenerative findings as above.4.Marrow signal characteristics are mildly heterogeneous and there are focal hyperintense lesions within the right lateral mass of C1, unchanged and potentially representing the patient's known multiple myeloma.