85 years Male (DOB:7/25/1931)Reason: hx of spinal stenosis, AV malformation, AVN of thoracic cord, and elevated PSA presenting with bilateral leg weakness History: bilateral leg weakness PROVIDER/ATTENDING NAME: GRACE E BERRY SERVICES ANCILLARY MRI thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. No abnormal lesions are identified in the thoracic spinal cord.There are degenerative changes present in the cervical spine associated with narrowing of neural foramina and the spinal canalLumbar spine:Five lumbar type vertebral bodies are presumed to be present. The conus medullaris on sagittal imaging is grossly intact.There is a superior endplate compression of L4 and inferior endplate compression of L3.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is bilateral facet and ligamentum flavum hypertrophy present. There is some disc desiccation and a disc bulge at this level. Overall this has not significantly progressed when compared to the prior exam to extent of visualization. There is some effacement of the fat at the right lateral recess which remains stable compared to the prior exam.At L4-5 there is mild anterior subluxation of L4 on L5 by approximately 5 mm. Previously this was slightly less. There is narrowing of the facet joints at this level. The facet joints appear narrowed on the current exam versus the prior exam. Additionally ligamentum flavum is much thinner on the current exam compared to the previous exam from 2005. Since the prior exam spinal stenosis has regressed compared to previous exam. The patient is status post laminectomy at this level.At L3-4 there is a disc bulge present associated with mild ligamentum flavum hypertrophy and facet hypertrophy. There is triangulation of the thecal sac at this level which has progressed since the prior exam. Overall there is a mild degree of spinal stenosis at this level.At L2-3 there is a broad-based right lateral disc protrusion present which was also present on the prior exam but appears to have progressed. There is now some encroachment of the nerve roots of the right lateral recess at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are multiple renal cysts present these can also be identified on the recent abdomen CT from 11/27/2015.
1.There are degenerative changes present in the lumbar spine associated with mild spinal stenosis at L3-4 which has progressed since the 2005 exam.2.The patient status post laminectomy at L4-5 where there is mild subluxation. Previous exam spinal stenosis at this level has been alleviated.3.There are endplate compressions present at the L3-4 disc level. These have developed since the previous exam.4.No marrow replacing lesions are appreciated within the lumbar spine.5.Although no lesions are appreciated within the thoracic spinal cord, motion artifact may obscure more subtle abnormalities including arteriovenous malformation.6.There are degenerative changes present in the cervical spine associated with narrowing of neural foramina and the spinal canal.7.Examination is degraded by artifact due to patient motion which will obscure more subtle abnormalities.