Male, 46 years old, with inhalation injury, found down. Assess for ligamentous injury. Mild reversal of the normal cervical lordosis is again seen. T1/T2 hyperintense signal within the C4 and C6 vertebral bodies is seen compatible with focal fat or hemangiomas. No evidence of significant marrow edema or concerning marrow replacement.There may be minimal residual STIR hyperintensity within the soft tissues between and around the spinous processes, but it is reduced from the prior examination. No epidural fluid collections are detected. Mild prominence of the dorsal epidural fat is seen at C4 and C5, and again in the thoracic region. Similar to the prior examination, the anterior spinal cord shows patchy increased T2 signal from C3 through C6. The cord remains impinged at these levels by posterior disc osteophyte complexes which are discussed by level as follows.C2-3: Mild facet hypertrophy. Thickening of the posterior longitudinal ligament but no significant disc osteophyte formation. No significant spinal canal or foraminal stenosis. No interval changes.C3-4: Facet hypertrophy. Posterior disc-osteophyte complex formation with a large central protruding component which impinges upon the spinal cord. Mild left foraminal narrowing. No interval changes.C4-5: Left facet hypertrophy. Posterior disc-osteophyte complex formation with a moderately sized central protruding component which impinges the spinal cord. No significant foraminal narrowing. No interval changes.C5-6: Left facet hypertrophy. Mild posterior disc-osteophyte complex formation. Small central protruding component which minimally impinges upon the spinal cord. Mild left foraminal narrowing. No interval changes. C6-7: Facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild left foraminal narrowing. No interval changes.C7-T1: Unremarkable.
1.Edema within the posterior paraspinal soft tissues seems to have decreased from the prior examination which may reflect healing soft tissue or ligamentous injury. No fluid collections are detected. No frankly disrupted ligaments are seen.2.The spinal cord remains impinged by disc osteophyte complexes at C3-4, C4-5 and C5-6. The spinal cord shows increased T2 signal at these levels, similar to prior, which may reflect myelomalacia and/or edema. The acuity of these disc protrusions is not entirely certain, though they may very well be chronic.