 Cervical Spine: Again seen are postsurgical changes of anterior cervical discectomy and fusion from C3 to C6. There appears to be solid osseous fusion across the vertebral bodies. Vertebral body heights are maintained. Alignment is maintained. Prominence of the dorsal epidural fat from the C6-C7 level extending inferiorly into the thoracic spine is again noted, not appreciably changed since outside study from 4/9/2015.Multilevel degenerative changes are again seen, individual levels as below:C2-3: Mild narrowing of the spinal canal with partial effacement of the ventral and dorsal thecal sac related to right paracentral disc osteophyte complex and ligamentum flavum thickening. There is mild to moderate right and no significant left neural foraminal stenosis.C3-4: No significant compromise to the spinal canal. There is moderate right and mild left neural foraminal stenosis related to uncovertebral hypertrophy and facet arthropathy. C4-5: No significant compromise to the spinal canal. Mild to moderate right and mild left neural foraminal narrowing.C5-6: No significant compromise to the spinal canal. Mild bilateral neural foraminal narrowing. T2 hyperintensity is noted in the dorsal cord posteriorly at this level. There is abnormal T2 hyperintensity involving the right hemicord at the upper C6 level.C6-7: There is moderate spinal canal stenosis related to disc osteophyte complex and ligamentum flavum thickening. There is mild to moderate bilateral neural foraminal stenosis, right relatively worse than left. Findings are not appreciably changed since outside prior study.C7-T1: No significant compromise to the neural foramina. Mild spinal canal stenosis related to epidural lipomatosis. No significant disc disease.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear grossly unremarkable. Partially imaged is opacification of the left mastoid air cells.Thoracic Spine: Postsurgical changes of thoracic laminectomy and fusion from T6 to T10 are again seen. Spinal canal is well decompressed at these levels. Epidural lipomatosis is again seen extending from the lower cervical spine to the T5-T6 level.At the T1-T2 level, there is moderate spinal canal stenosis with mild flattening of the cord. No cord signal abnormality at this level is appreciated. There is also moderate neural foraminal stenosis, right worse than left related to facet arthropathy.At the T2-T3 level, there is moderate spinal canal stenosis related to epidural lipomatosis with mild cord flattening. No cord signal abnormality. There is mild right neural foraminal narrowing. No significant left neural foraminal narrowing.From T3-T4 to the T12-L1 levels, there is no significant spinal canal stenosis. Neural foramina also appear patent. Susceptibility artifact slightly limits evaluation however no new cord signal abnormality in the mid or lower thoracic cord is appreciated. Prominent ventral bridging osteophytes suggestive of DISH again noted.
1. Postsurgical changes of ACDF from C3 to C6 again seen. Degenerative changes in the cervical spine with moderate spinal canal stenosis at C6-C7 related to disc osteophyte complex and epidural lipomatosis is not significantly changed since 4/9/2015.2. Cord signal abnormality involving the cervical cord at the C5-C6 level, predominantly on the right is also not significantly changed and consistent with myelomalacia.3. There is moderate spinal canal stenosis with mild cord flattening at the T1-T2 and T2-T3 levels and to a mild degree at C7-T1. These findings are predominantly related to epidural lipomatosis. No associated cord signal abnormality is definitively appreciated. There is also neural foraminal stenosis right worse than left at T1-T2.4. Postsurgical changes of epidural fat resection, laminectomy, and fusion from T6 through T10 again seen. Spinal canal remains well decompressed at these levels.