History of spinal cord injury following a fall in 2012 resulting in cervical cord impingement requiring C3-C6 laminectomies and C3-C5 instrumented fusion. New upper extremity numbness post assault 2 weeks ago. There is mildly increased STIR signal within bone marrow of the C5, C6 and C7 vertebral bodies with subtle hypointensity on T1 and may reflect edema. There is also edema in and around the left T1 transverse process and adjacent ribs. The vertebral bone marrow signal is otherwise less fatty than expected, which may reflect red marrow reconversion. There appears to be trace left-sided epidural high T2 and low T1 signal at the C6 level anteriorly. There are postoperative findings related to previous C3-C6 laminectomies and C3-C5 instrumented fusion. There is reversal of the usual cervical lordosis. The vertebral column alignment is within normal limits otherwise. The vertebral body heights are preserved. The thecal sac is expanded at the laminectomy levels. However, C6-C7 and C7-T1 disc-osteophyte complexes cause slight spinal canal stenosis. There is no significant spinal canal narrowing otherwise. The focal T2 hyperintensity within the spinal cord centrally at the upper C4 level in unchanged. The remainder of the spinal cord displays normal signal and morphology.
1.No evidence of spinal cord compression. 2.Focal central T2 hyperintensity in the cervical spinal cord has not changed since 2012 and may represent myelomalacia. 3.Mildly altered signal in the marrow of the corresponding vertebral bodies, which likely represents edema, and trace left-sided epidural high T2 and low T1 signal at the C6 level anteriorly, which may represent an epidural hematoma. 4.Edema in and around the left T1 transverse process and adjacent ribs is likely related to the fracture that is better depicted on CT.5.Findings related to previous cervical spine laminectomies and instrument fusion, as described above, with residual C6-C7 and C7-T1 disc-osteophyte complexes cause slight spinal canal stenosis.