Bilateral lower extremity numbness, tingling, genital numbness. Evaluate for cord compression. The vertebral bodies are appropriate in the overall alignment and height. Degenerative changes are noted in the cervical spine with disc osteophyte complex at the C4-C5 level resulting in moderate spinal canal stenosis. There is possible associated cord signal abnormality. Abnormal cord signal is also suspected in the upper cervical cord at the C1-C2 level. Questionable patchy cord signal abnormality involving the thoracic cord is also suspected although examination is suboptimal for the evaluation of cord signal. No high-grade stenosis in the thoracic spine is seen. In the lumbar spine, there are degenerative changes including disc bulge at L3-L4 which results in mild to moderate spinal canal stenosis. No appreciable high-grade stenosis within the lumbar spine is demonstrated. Facet arthropathy is noted in the lumbar spine with distention of the L3-L4 facet joints.
This is a limited exam specific for the exclusion of cord compression only and does not adequately assess more subtle lesions such as intrinsic cord abnormalities. Patchy cord signal abnormality is suspected, specifically at C1-C2 and questionably at additional levels in the thoracic spine. There is moderate spinal canal stenosis at the C4-C5 level related to prominent disc osteophyte complex. Mild to moderate lumbar spinal canal stenosis at the L3-L4 level also noted. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine. Suggest dedicated cervical and lumbar spine MRI and possibly brain and thoracic MRI to better assess the etiology of the multiple areas of cord signal abnormality (such as demyelinating/inflammatory disease).