68-year-old male with upper and lower extremity weakness, lower back pain and CT findings worrisome for stenosis CERVICAL SPINE:Vertebral body heights are intact. There is multilevel disk desiccation, however disk height is preserved. No abnormal marrow signal. Signal within the cord is normal. Alignment is anatomic. No abnormal enhancement.C2-C3: No spinal or neuroforaminal stenosis.C3-C4: Mild endplate and uncovertebral osteophytes. Mild bilateral neuroforaminal stenosis. No spinal canal stenosisC4-C5: Mild endplate and uncovertebral osteophytes. Mild bilateral neuroforaminal stenosis. No spinal canal stenosis.C5-C6: Mild endplate and uncovertebral osteophytes. Mild bilateral neuroforaminal stenosis. No spinal canal stenosis.C6-C7: Mild endplate and uncovertebral osteophytes. No spinal or neuroforaminal stenosis. C7-T1: No spinal or foraminal stenosisTHORACIC SPINE:Vertebral body heights are intact. There is multilevel disk desiccation with mild loss of disk height from T7 to T11. A Schmorl's node is present within the T8 vertebral body. No abnormal marrow signal. No abnormal enhancement. No abnormal signal within the cord. Thoracic spine is mildly narrowed throughout, likely congenital. No significant spinal or neural foraminal stenosis throughout the thoracic spine.LUMBAR SPINE:Please note that there is lumbarization of S1 counting from C2. The vertebrae is labeled L1 to L6 on the present study correspond to T12 to L5 on the prior CT.Vertebral body heights are maintained. There is minimal reversal of lumbar lordosis L5 There is multilevel disk desiccation, particularly at L3-L4, L4-L5 and L5-S1. There is enhancement of the cauda equina at L3-L4 where there is moderate to severe narrowing of the canal. The conus ends at L2. Signal within the distal cord is normal. 13 rib pairs are identified with ribs at L1.L1-L2: No central or neuroforaminal stenosis.L2-L3: Mild diffuse disk bulge and ligamentum flavum thickening. Facet arthropathy. No central canal stenosis. Moderate bilateral neural foraminal stenosis.L3-L4: Diffuse disk bulge and ligamentum flavum thickening. Facet arthropathy. Ligamentum flavum cyst. Severe central canal stenosis. Moderate left and mild right neural foraminal stenosis.L4-L5: Diffuse disk bulge, ligamentum flavum thickening and facet arthropathy producing moderate central canal stenosis. Mild bilateral neuroforaminal stenosis. Mild/minimal subluxation of L4 on L5. Moderate right neuroforaminal stenosisL5-L6: Mild diffuse disk bulge, facet arthropathy and ligamentum flavum thickening. Mild/minimal subluxation of L5 on L6. Moderate right neuroforaminal stenosis. Mild to moderate central canal stenosis.
1.Please note that there are 6 lumbar type vertebra and 13 pairs of ribs present. This affects enumeration of lumbar vertebrae.2.There is moderate to severe lumbar spinal stenosis due to degenerative changes at L3-L4. The cauda equina is compressed and enhances at L3-L4.3.Moderate spinal stenosis due to degenerative changes at L4-5 associated with mild/minimal subluxation.4.Mild to moderate spinal stenosis due to degenerative changes at L5-6 associated with mild/minimal subluxation.5.There are degererative changes in the cervicla spine with mild multilevel bilateral neural foraminal encroachment of exiting nerve roots in the cervical spine but without spinal stenosis.6.There are minor degenerative changes in the thoracic spine.