Clinical question: SC abnormality? Signs and symptoms coronal previous neck surgery right upper extremity radicular pain. Pre-and post-enhanced cervical MRI:Examination demonstrates a stable post operative changes Chiari decompression with resultant expansion of subarachnoid space at the surgical site similar to prior exam.Examination redemonstrates a mildly expansile syrinx of cervical cord extending from C1 to the uppermost visualized thoracic cord.The syrinx at C2 level measures 4.4-mm in transverse axis which is smaller compare to prior study measurements of 6.1-mm at the same level. There is however suggestion of mild interval increased size of syrinx more inferiorly compared to prior exam at C4 and C5 levels. At C5 it measures 3.5 mm in transverse axis compared to prior study measurements of 2.5-mm.post-enhanced images demonstrate no abnormal enhancement of the cord, leptomeninges or the vertebral column.Degenerative changes of cervical spine results in mild central spinal stenosis at C3 -- C4 and C4 -- C5 levels.Mild bilateral neural foraminal compromise at C3 -- C4, moderate to severe bilateral neural foraminal compromise at C4 -- C5, severe right and mild left neural foraminal C5 -- C6, mild bilateral neural foramina compromise at C6 -- C7 and significant right neural foramina compromise at C7 -- T1 is also noted.
1.Stable postoperative changes of Chiari decompression since prior exam.2.Stable extent of mildly dilated syrinx of cervical cord extending from T1 through the entire cervical cord and into the upper thoracic.3.Minimal interval decrease transverse caliber of syrinx at C1 -- C2 level and sulcal interval increased at C4 and C5 levels.4.No abnormal enhancement of the cord, leptomeninges or the spinal column on post infused images.5.Degenerative changes of cervical spine results in a central spinal stenosis at C3 -- C4 and C4 -- C5 levels. Multi-level neural foraminal compromise is also present as detailed per level above.