54-year old male with swelling and tenderness; assess for infection of the soft tissues and bones Mild straightening of the normal cervical lordosis is seen which may be due to patient positioning versus muscle spasm. Vertebral body heights are maintained without evidence of fracture. The prevertebral soft tissues are unremarkable. Multiple cervical lymph nodes are seen, none pathologically enlarged.Status post bilateral laminectomy and removal of the spinous processes of C3 and C4 with fluid accumulation seen dorsal to the laminectomy site without significant mass effect on the cord/thecal sac. The spinal subarachnoid space is well visualized without definite evidence of abscess. Fluid collection is also seen along the incision site with fluid seen accumulating in the subcutaneous tissues. The paraspinal muscles appear normal in density. These findings are consistent with the expected post operative findings of a bilateral laminectomy; however correlation with the patient's clinical history and symptoms is recommended. If high clinical concern for infection, contrast enhanced MRI is recommended.Multilevel degenerative changes are again seen appearing similar to the prior study. No significant compromise of the spinal canal.Degenerative changes as described below:C2-3: Prominent disk bulge is seen impressing on the spinal cord with bilateral neural foramina narrowing and facet joint hypertrophy.C3-4: Disk/osteophyte complex is seen impressing on the spinal cord which is unchanged in size and degree of cord compression. Bilateral neural foramina narrowing and facet joint hypertrophy.C4-5: Disk/osteophyte complex is seen abutting the spinal cord. Bilateral neural foraminal narrowing and facet joint hypertrophy. Extensive artifact limits evaluation of the spinal canal inferior to C5.
1. Status post bilateral laminectomy at C3 and C4 with fluid accumulation dorsal to the laminectomy site which is consistent with expected postoperative changes. Recommend correlation with patient's symptoms and clinical history. If clinical concern for infection, recommend contrast enhanced MRI for further evaluation.2. Extensive multilevel degenerative disk disease, as described above, appearing similar to the prior study.