Post polio syndrome, status post decompressive surgery in 2004; rule out compression of cord. Prior history of cervical myelopathy and polio now with increasing lower extremity weakness. Cervical spine: Craniovertebral junction appears within normal limits. There are post operative changes related to C4 corpectomy and C3-C5 fusion. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits and unchanged from previous.The cervical spinal cord demonstrates linear areas of increased T2 signal extending from C3 to C5, consistent with myelomalacia which remains unchanged from previous exam.Degenerative changes are seen in the cervical spine as described below:C2-3: There is a central disc osteophyte complex with effacement of the ventral thecal sac, similar to previous exam. There is uncovertebral hypertrophy resulting in mild narrowing of the right neural foramen. No significant spinal canal stenosis. No interval changes.C3-4: No significant disc bulge or compromise to the spinal canal or neural foramina.C4-5: Posterior disc osteophyte complex with mild bilateral foraminal narrowing. There is no significant spinal canal stenosis. No interval changes.C5-6: There is a right paracentral focal disc protrusion with narrowing of the bilateral neural foramina. There is no spinal canal stenosis. No interval changes.C6-7: There is mild disc bulge resulting in mild bilateral neuroforaminal narrowing. No significant compromise to the spinal canal. No interval changes.C7-T1: There is disc bulge resulting in effacement of the ventral thecal sac, unchanged from previous. There is moderate bilateral neural foraminal narrowing. There is minimal if any spinal canal stenosis. No interval changes.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Lumbar spine: There is significant scoliosis of the lumbar spine. There are post surgical changes in the lumbar spine with metallic artifact at S1 and deformation extending through most of the lumbar region on the right. For the purposes of this dictation last fully formed disc is designated L5-S1. The vertebral body heights and disc heights are maintained and unchanged.No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus is low-lying with the conus terminating at the L3 level. Paraspinal soft tissue structures are unremarkable.At L1-L2, there is no significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis.At L2-L3, there is no significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis.. At L3-L4, there is no significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis..At L4-L5, there is no significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis..At L5-S1, there is no significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis.
1. Postsurgical changes of anterior corpectomy and fusion of the cervical spine from C3 through C5. There is redemonstration of myelomalacia of the cord extending from C3 through C5, without interval changes.2. There are multilevel degenerative disc changes in the cervical spine, overall appearing similar to the previous exam. Degenerative changes are worst at C7-T1 reflecting moderate bilateral neural foraminal narrowing and minimal if any spinal canal stenosis.3. Severe scoliosis and postoperative changes in the lumbar spine. No significant spinal stenosis or neural neuroforaminal compromise noted.4. Low-lying spinal cord with conus terminating at the T3 level.