Walking trouble, right leg weakness, spastic legs and significant sensation loss. Examination is motion degraded. Vertebral body heights in the cervical spine are normal. Alignment is grossly maintained. There is congenital narrowing of the cervical spinal canal with superimposed degenerative changes similar to prior study from 2/6/2015.The cervical cord demonstrates volume loss and T2 hyperintensity at the C4-C5 level consistent with myelomalacia and similar to prior. No new cord signal abnormality.There is ligamentum flavum thickening at the C1-C2 level with effacement of the dorsal thecal sac and mild spinal canal stenosis at this level. Degenerative changes are seen in the cervical spine at additional levels as described below:C2-3: Mild spinal canal stenosis which is predominantly on a congenital basis. No significant neural foraminal stenosis.C3-4: Mild spinal canal stenosis related to central osteophyte. Mild to moderate right neural foraminal stenosis related to uncovertebral hypertrophy. No significant left neural foraminal narrowing.C4-5: There is a disc osteophyte complex, prominent ligamentum flavum thickening, and uncovertebral hypertrophy. There is severe spinal canal stenosis at this level with flattening of the cord. There is T2 hyperintensity in the cord which is also again seen. No significant change allowing for differences related to motion degradation when compared to prior MRI from 2/6/2015. There is moderate to severe right and moderate left neural foraminal stenosis. Prominent right-sided facet arthropathy.C5-6: Small disc osteophyte complex and uncovertebral hypertrophy as well as ligamentum flavum thickening. There is mild to moderate spinal canal stenosis. There is mild to moderate left and mild right neural foraminal stenosis.C6-7: No significant compromise to the spinal canal or neural foramina. Small disc osteophyte complex and uncovertebral hypertrophy. There is mild spinal canal narrowing which is predominantly on a congenital basis. There is mild left and minimal right neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Multilevel degenerative changes in the cervical spine which are not significantly changed since 2/6/2015. There is severe spinal canal stenosis at the C4-C5 level with T2 hyperintensity within the cord and volume loss likely representing myelomalacia. Additional levels as detailed above.