Balance issues and clumsiness Vertebral body heights in the cervical spine are normal. There is been progression of ankylosis involving the C3-C4 intervertebral disc space. There is minimal retrolisthesis of C4 on C5 and C5 on C6 and minimal anterolisthesis of C7 on T1. Alignment is similar to prior.Advanced degenerative changes are again seen throughout the cervical spine. There is abnormal T2 hyperintensity in the cervical cord at the C4, C5, and to a lesser degree C6 levels with cord parenchymal thinning consistent with myelomalacia and similar to prior. No new cord signal abnormality. Again noted is probable ossification of the posterior longitudinal ligament from C3-C4 through C6-C7. Individual levels as below:At C2-C3, there is no disk pathology or stenosis.At C3-C4, there is a posterior osteophyte disk complex, PLL thickening/calcification, and bilateral uncovertebral hypertrophy. There is volume loss resulting in preservation of the ventral and dorsal subarachnoid spaces. There is moderate bilateral foraminal narrowing. At C4-C5, there is a central disc osteophyte complex with indentation of the ventral cord. There is moderate to severe spinal canal stenosis which appears slightly worse in the interval. There is moderate left and mild-moderate right foraminal narrowing related to uncovertebral hypertrophy.At C5-C6, there is a disc osteophyte complex with significant right greater than left uncovertebral hypertrophy. There is moderate to severe spinal canal stenosis similar to prior. There is moderate to severe bilateral neural foraminal narrowing as well. Ligamentum flavum thickening is present.At C6-C7, there is a disc osteophyte complex resulting in mild central spinal canal stenosis. There is bilateral uncovertebral hypertrophy. There is severe left and moderate right foraminal narrowing. Ligamentum flavum thickening again seen.At C7-T1, there is no significant disk bulge or spinal canal or neural foraminal stenosis.Patchy T2/STIR hyperintensity is again seen within the pons likely related to chronic small vessel ischemic disease.
1. Advanced degenerative changes in the cervical spine are again seen. Again seen is T2 signal abnormality involving the C4, C5, and to a lesser degree C6 levels with thinning of the cord consistent with myelomalacia. No new cord signal abnormality.2. There is moderate to severe spinal canal stenosis at C4-C5 and C5-C6 which appears minimally worse in the interval at the C4-C5 level and not significantly changed at the C5-C6 level compared to 7/20/2013.3. There is also neural foraminal stenosis involving the C3-C4 to the C6-C7 levels as detailed above and similar to prior.4. Again seen is thickening of the posterior longitudinal ligament from C3 to C7 with low T1 and low T2 signal which may represent ossification but can be better assessed with CT.