Radicular pain in the left upper extremity, left C5/6. History of surgery to cervical spine. Craniocervical junction is within normal limits. The vertebral body heights are preserved. The spinal cord displays normal signal and morphology. Bone marrow signal is benign. There is straightening of the cervical spinal curvature similar to prior and grade 1 anterolisthesis of C7 on T1 measuring 3 mm, which is unchanged. Again seen is anterior cervical spinal fusion at C6-C7 with intervertebral disc spacer and wide decompressive laminectomies at C3-C7. C6 screw fractures better seen on prior CT.Multilevel degenerative changes are again seen which are not significantly changed since 3/28/2015. There are endplate degenerative changes at C4-C5 with severe loss of disc space. There is also mild loss of disc height at C3-C4, moderate loss of disc height at C5-C6, and severe loss of disc height at C7-T1. There is also mild multilevel facet arthropathy. The paravertebral soft tissues are unremarkable. There is a 10 mm nodule in the left thyroid lobe similar to prior. No abnormal enhancement in the spine.Individual levels as below:C2-C3: Unchanged small left paracentral disc osteophyte complex and ligamentum flavum thickening with mild spinal canal stenosis. No neural foraminal stenosis.C3-C4: Status post laminectomy. Large left paracentral osteophyte contributing to mild flattening of the left ventral cord similar to prior. There is likely mild mass effect on the left-sided nerve root although more laterally the neural foramen is patent.C4-C5: Status post laminectomy. Disc osteophyte complex with left uncinate spur, contributing to mild left foraminal stenosis. No significant right foraminal stenosis. These findings are also similar to prior.C5-C6: Status post laminectomy. Small disc osteophyte complex. Minimal narrowing of the left neural foramen as before. Right neural foramen is patent. Findings are similar to prior.C6-C7: Status post laminectomy. Disc osteophyte complex with large central osteophyte, contributing to mild flattening of the ventral cord. There is mild to moderate left foraminal stenosis. Findings are similar to prior.C7-T1: Status post laminectomy. No significant spinal canal or right neural foraminal stenosis. Mild to moderate left neural foraminal stenosis similar to prior. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Multilevel degenerative changes in the cervical spine are again seen and not significantly changed since prior study from 3/28/2015. There is multilevel, mild or mild to moderate left-sided neural foraminal stenosis, as described above. There are also prominent left paracentral C3-C4 and central C6-C7 disc osteophyte complexes with mild impression on the ventral aspect of the cord. Spinal canal remains otherwise surgically well decompressed without evidence of high-grade stenosis at any level.