Evaluate for cord compression. Lower extremity weakness, falls, urinary frequency, pain. Thoracic:Vertebral body heights in the thoracic spine are normal. Alignment is normal. Bone marrow signal is within normal limits. Limited evaluation of the cervical spine on the sagittal counting sequence again demonstrates a low T1 and T2 signal structure dorsal to the C2-C3 disc space which may represent focus of ligamentous calcification or extruded disc material. There appears to be at least mild spinal canal stenosis at this level.At multiple levels in the thoracic spine, again seen is low T1 and low T2 signal involving the dorsal spinal canal likely representing ligamentum flavum calcifications. These lesions are seen at T2-T3, T3-T4, T4-T5, and T6-T7 levels in the upper thoracic spine without significant spinal canal stenosis. A larger focus which extends from the upper T9 to the upper T10 level which results in moderate to severe spinal canal stenosis and compresses the thoracic cord; no significant change. There is abnormal T2 signal within the cord at the T9-T10 level similar to prior although better imaged on the current study. More inferiorly, mild spinal canal narrowing is seen at T10-T11, moderate spinal canal narrowing at the T11-T12 level, and moderate to severe canal narrowing at the T12-L1 level at the level of the conus related to ligamentous flavum calcifications. Abnormal T2 signal in the cord at the T12-L1 level is also noted, and also similar to prior.Mild foraminal narrowing is seen associated with the aforementioned calcifications. No high-grade foraminal stenosis. No abnormal enhancement. Right thyroid nodule.Lumbar spine:The most inferior well-defined disc space is labeled L5-S1. Vertebral body heights in the lumbar spine are normal. Alignment is grossly maintained. Conus is in normal position at the mid L2 level. Bone marrow signal is benign. No suspicious enhancement.Multilevel degenerative changes are seen as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L2-L3: Small left foraminal disc protrusion and facet arthropathy contribute to mild narrowing of the left neural foramen. There is also mild spinal canal narrowing related to ligamentum flavum thickening and facet arthropathy. Right neural foramen is patent.L3-L4: Right foraminal disc protrusion with moderate narrowing of the right neural foramen. There is mild spinal canal and mild left neural foraminal narrowing.L4-L5: There is moderate to severe spinal canal stenosis related to disc protrusion, ligamentum flavum thickening, and facet arthropathy. There is moderate left and mild to moderate right neural foraminal stenosis.L5-S1: Central disc protrusion without significant spinal canal narrowing. There is moderate to severe right neural foraminal stenosis related to facet arthropathy and mild to moderate left neural foraminal narrowing.
1. Again seen is high-grade spinal canal stenosis at the T9-T10 and T12-L1 levels related to what likely represents ligamentum flavum calcifications with compression of the cord as well as T2 cord signal abnormality. These findings are similar to prior MRI from 7/22/2015. There is lesser degree of spinal canal stenosis related to the same process at additional levels as detailed above.2. Degenerative changes in the lumbar spine with moderate to severe spinal canal stenosis at the L4-L5 level. There is also neural foraminal stenosis at multiple levels in the lumbar spine as detailed above.