Chronic low back pain, recent falls and urinary incontinence. Evaluate for cord compression. There is multilevel degenerative spondylosis in the cervical spine with impingement upon the spinal cord from C3-4 to C6-7. There is apparent high signal on STIR in the spinal cord at these levels. There is focal ligamentum flavum thickening at T2-3 and T5-6 without indentation of the spinal cord. There is also degenerative spondylosis in the lumbar spine superimposed upon congenital narrowing of the lower lumbar spinal canal. In particular, there disc herniations at L4-5 and L5-S1 with moderate narrowing of the spinal canal and severe right L5-S1 neural foraminal narrowing, and mild to moderate left L4-5 and L5-S1 and right L4-5 neural foraminal narrowing. There is 5 mm of anterolisthesis of L5 on S1. The vertebral body heights are preserved, but there is endplate irregularity and degenerative bone marrow signal alteration at L4-5 and L5-S1. There is a low signal subcentimeter nodule in the posterior neck subcutaneous tissues, which may represent an inclusion cyst, for example. There is a partially imaged mass in the the right lung.
1. Multilevel degenerative changes particularly in the cervical spine with associated impingement upon the spinal cord from C3-4 to C6-7. Apparent high signal on STIR in the spinal cord at these levels may be artifactual or represent edema or myelomalacia. Dedicated cervical spine imaging may be useful for further evaluation.2. Focal ligamentum flavum thickening at T2-3 and T5-6 without indentation of the spinal cord. 3. Degenerative spondylosis in the lumbar spine superimposed upon congenital narrowing of the lower lumbar spinal canal with spinal canal and neural foraminal stenoses from L4 through S1. 4. A partially imaged mass in the the right lung may represent a neoplasm. Dedicated chest CT is recommended for further imaging.Findings were discussed with Dr. Colton Clay by phone on 12/22/2016 at 12:10 PM. 