 Cervical spine:Multilevel degenerative changes affect the cervical spine with anterior osteophyte formation and multilevel disc desiccation affecting C3 through C6 along with mild endplate irregularity at these levels. There is a grade I retrolisthesis of C5 on C6, measuring 3 mm. Vertebral body heights are preserved.At the C2/C3 level, there is no significant canal stenosis. Facet and uncovertebral hypertrophy cause moderate, left greater than right, bilateral neural foraminal stenosis.At the C3/4 level, a small posterior disc-osteophyte complex causes moderate canal stenosis along with ligamentum flavum thickening/facet hypertrophy leading to mild right and moderate to severe left neural foraminal stenosis. There is no significant signal cord abnormality.At the C4/C5 level, a moderate posterior disc-osteophyte complex causes moderate to severe canal stenosis. There is a focus of increased T2 signal within the spinal cord at this level which may be secondary to compressive myelopathy. Facet and ligamentum flavum hypertrophy also contribute to moderate to severe right and severe left neural foraminal stenosis.At the C5/6, a small posterior disc-osteophyte complex causes moderate to severe canal stenosis. Bilateral ligamentum flavum, uncovertebral, and facet hypertrophy contribute to severe bilateral neural foraminal stenosis.At the C6/7, a small posterior disc-osteophyte complex causes mild canal stenosis. There is ligamentum flavum and facet hypertrophy contributing to mild to moderate bilateral neural foraminal stenosis.At the C7/T1, there is no significant canal stenosis. There is left greater than right facet hypertrophy with mild right and moderate left neural foraminal stenosis.Lumbar spine:There is anatomic alignment of the lumbar spine. Vertebral body heights are preserved. Signal within the visualized cord is within normal limits. Developmental narrowing of the mid to distal lumbar spinal cord is again identified. Multilevel degenerative changes of the lumbar spine appears similar to that described on prior study from 1/19/2016. An asymmetric heterogeneous abnormal signal intensity collection within the subcutaneous tissues overlying the right gluteal musculature at the level of L5 appears similar to the prior study. There is nodular thickening within the partially imaged left adrenal gland measuring up to 2.0 x 2.1 cm. There is also thickening of the partially imaged right adrenal gland. There is a 1.2 cm hyperintense lesion within the left kidney which likely represents a simple cyst.
1. Multilevel degenerative changes of the cervical spine with grade I retrolisthesis of C5 on C6 and multilevel moderate to severe spinal canal stenosis and neural foraminal stenosis as described above, which is most prominent at C4/C5 where there is signal abnormality within the cord which may be secondary to compressive myelopathy.2. No significant interval change in degenerative changes of the lumbar spine as described on recent MRI.3. Heterogeneous collection within the right subcutaneous soft tissues at the level of L5 is similar in appearance. This may represent a small fluid collection/hematoma; correlation with physical examination and history of trauma/procedure is suggested. 4. Thickening of the adrenal glands with more focal nodular appearance on the left, which is unchanged; comparison to prior outside body imaging is suggested if available, otherwise, dedicated adrenal imaging may be considered if clinically warranted.