Male, 77 years old, with mixed neuropathy and worsening ambulatory status. Cervical:Straightening of the cervical lordosis is seen. Spinal alignment is otherwise unremarkable. Vertebral body heights are preserved. Marrow signal characteristics are within normal limits. Postoperative changes are seen compatible with laminoplasty from C3 through C6. Patchy cord signal abnormality and loss of cord volume are seen from C4-5 through C6-7. No evidence of pathologic cord enhancement is detected.C2-3: Mild facet arthropathy. No significant spinal canal or foraminal stenosis. C3-4: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Severe right and moderate left foraminal narrowing. C4-5: Mild posterior disc-osteophyte complex formation. No spinal canal stenosis. Moderate to severe bilateral foraminal narrowing. C5-6: Facet arthropathy and ligamentum flavum thickening particularly on the left. Mild spinal canal stenosis. Severe bilateral foraminal narrowing. C6-7: Facet arthropathy. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate bilateral foraminal narrowing. C7-T1: Facet arthropathy. No significant spinal canal or foraminal compromise. Thoracic:Spinal alignment is anatomic. Vertebral body height and morphology are within normal limits. No pathologic marrow signal abnormality is observed. There is a 3 mm focus of T2 hyperintensity within the spinal cord at T10. On postcontrast images, this focus enhances. In addition, there are tortuous prominent vascular structures running along the dorsal surface of the distal spinal cord.The intervertebral discs are preserved. No areas of significant spinal canal or foraminal compromise are detected.Lumbar:Evidence of posterior instrumented fusion is seen from L3 through S1. Laminectomy has also been performed through this region. Spinal alignment is grossly anatomic. Vertebral body height and morphology are within normal limits. Increased STIR signal is seen within the anterior inferior aspect of the L2 vertebral body which is nonspecific but may be degenerative in nature.Within the limitations of metal artifact, the distal spinal cord and conus show no specific abnormalities. No definite pathologic intraspinal enhancement is seen.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: Facet hypertrophy and ligamentum flavum thickening. Disc bulging. Moderate generalized spinal canal stenosis with some crowding of the cauda equina. Moderate right and mild left foraminal narrowing. L3-4: Postoperative changes. No spinal canal or foraminal stenosis. L4-5: Postoperative changes. No spinal canal or foraminal stenosis. L5-S1: Postoperative changes. No spinal canal or foraminal stenosis.
1.Evidence of laminoplasty is seen in the cervical region. Areas of chronic appearing myelomalacia are noted from C4-5 through C6-7 which likely relate to prior degenerative impingement. Although no high-grade spinal canal stenosis is seen in the cervical region, scattered foraminal narrowing is noted, severe at several levels.2.Prominent enhancing vascular structures are seen along the dorsal surface of the lower spinal cord, along with a possible intramedullary focus of enhancement at T10. Findings are concerning for a spinal arteriovenous shunting lesion. Spinal angiography would provide the definitive assessment for these findings. Consultation with neurointerventional radiology is recommended.3.Findings are seen compatible with posterior instrumented fusion and spinal canal decompression in the lumbar spine. No residual spinal canal or foraminal compromise is seen in the fused segments from L3 through S1. However, at L2-3, disc bulging and posterior element hypertrophy do contribute to a moderate spinal canal stenosis and bilateral foraminal narrowing. Edema within the anterior inferior L2 vertebral body is nonspecific but potentially related to endplate degeneration.