Bilateral upper extremity weakness and hyperreflexia, status post MVA Cervical: Craniovertebral junction appears within normal limits. There is evidence of osseous fusion involving the C5-C7 vertebral bodies which is postsurgical. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from mild loss of cervical lordosis. Bone marrow signal is benign with T1 hyperintense lesion involving the C7 vertebral body compatible with a hemangioma..The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is mild right neural foraminal narrowing related to uncovertebral hypertrophy and facet arthropathy. No significant compromise to the spinal canal or left neural foramen.C4-5: Disc osteophyte complex and prominent uncovertebral hypertrophy on the left. There is partial effacement of the ventral thecal sac without significant spinal canal stenosis at this level overall. There is moderate left and mild right neural foraminal stenosis.C5-6: No significant compromise to the spinal canal or neural foramina. There is mild effacement of the ventral thecal sac.C6-7: No significant compromise to the spinal canal or neural foramina. There is mild effacement of the ventral thecal sac.C7-T1: There is mild left neural foraminal stenosis related to facet arthropathy. No significant compromise to the spinal canal or right neural foramen.Small perineural cysts incidentally noted at C6-C7 and C7-T1. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Thoracic: Thoracic vertebral body heights are maintained. Alignment is maintained. There is trace prominence of the central canal/tiny syrinx involving the lower thoracic cord, measures 1.3 mm in the AP dimension, and is of doubtful significance. Thoracic cord signal is otherwise unremarkable. Bone marrow signal is benign with no suspicious lesions. Scattered foci of T1 hyperintensity are compatible with hemangiomas and focal fat.No significant spinal canal stenosis is seen. Degenerative changes include partial effacement of the dorsal thecal sac at the T9-T10 level related to ligamentum flavum thickening and facet arthropathy. There is mild right T1-T2 neural foraminal stenosis. There is also mild neural foraminal stenosis at the T5-T6 and T6-7 levels. Small multiple Schmorl's nodes are noted in the lower thoracic spine.T2 hyperintense lesion is partially imaged involving the right hepatic lobe. Small left renal cyst is also noted.
1. Evidence of remote anterior cervical fusion involving the C5 to C7 vertebral bodies. There is no evidence of high-grade spinal canal stenosis at any level in the cervical spine or evidence of cervical cord signal abnormality.2. Adjacent segment disease with degenerative changes at C4-C5, where there is moderate left and mild right neural foraminal stenosis. There is also partial effacement of the ventral thecal sac at the C4-C5, C5-C6, and C6-C7 levels. Additional levels as detailed above.3. Mild degenerative changes in the thoracic spine without significant spinal canal stenosis at any level. There is trace prominence of the central canal in the distal thoracic cord which is of doubtful clinical significance. Thoracic cord signal is otherwise unremarkable.