Lower extremity numbness Cervical: Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. Alignment is maintained. Bone marrow signal is within normal limits. Abnormal T2 signal is noted involving the right central and dorsal cervical cord at the C1-C2 level. Abnormal T2 signal is also noted within the right lateral aspect of the cervical cord at the mid C2 level, well seen on sagittal STIR image 7/11. Abnormal T2 signal is also noted within the cervical cord at the C4-C5 level. Small focus of T2 hyperintensity is also noted within the dorsal aspect of the cord at the midline and slightly to the left of midline at the C5-C6 level and also noted on recent cord compression protocol MRI study.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: No significant compromise to the spinal canal or neural foramina.C4-5: There is a disc osteophyte complex with central disc protrusion as well as ligamentum flavum thickening posteriorly. There is moderate spinal canal stenosis including mild flattening of the cervical cord. There is abnormal T2 signal centrally within the cord at this level. There is mild bilateral neural foraminal narrowing related to uncovertebral hypertrophy.C5-6: No significant compromise to the spinal canal or neural foramina.C6-7: No significant compromise to the spinal canal or neural foramina.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.Lumbar:Five lumbar type vertebral bodies are present. Vertebral body heights are within normal limits. Alignment is within normal limits. Bone marrow signal is benign. The conus medullaris is normal in position. Abnormal T2 signal is noted in the ventral cord at the upper T12 level on the sagittal T2 and STIR sequences.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: There is disc desiccation and diffuse bulge which along with ligamentum flavum thickening, epidural fat, and facet arthropathy result in mild to moderate spinal canal stenosis. There is bilateral facet arthropathy with distention of the facet joints. Tiny synovial cyst is noted posterior to the inferior aspect of the left L3-L4 facet joint left. There is mild right and minimal left neural foraminal narrowing.L4-L5: No significant disc disease. No spinal canal or neural foraminal stenosis.L5-S1: No significant disc disease. No spinal canal or neural foraminal stenosis.Paraspinous soft tissues are within normal limits.
1. Multiple foci of T2 signal abnormality within the cord at the right C1-C2, right lateral mid C2, dorsal C5-C6, and ventral T12 levels. These foci are of indeterminate age but suggest demyelinating or other chronic inflammatory etiologies. Brain MRI as well as postcontrast imaging may be helpful if there is suspicion for an active inflammatory process.2. Degenerative changes in the cervical spine with moderate cervical spinal canal stenosis at the C4-C5 level related to central disc protrusion with mild cord flattening. There is associated abnormal T2 signal in the cord at the C4-C5 level.3. Degenerative changes in the lumbar spine with mild to moderate spinal canal stenosis at L3-L4. Otherwise no high-grade spinal canal stenosis in the lumbar spine is appreciated.