Female, 59 years old, with back pain and new incontinence. Evaluate for cauda equina syndrome. Cord compression protocol:No evidence of acute cord compression is seen. Multilevel disc osteophyte formation is seen at C4-5 and C5-6 as well as L4-5 resulting in some degree of spinal canal narrowing. These findings are better assessed on dedicated imaging. No epidural abnormalities are suspected. No pathologic marrow replacement or edema is seen.Cervical spine:Image quality is limited by motion artifact. Sagittal alignment is grossly anatomic. Vertebral body heights are preserved. No pathologic marrow replacement or edema is seen. No definite areas of spinal cord signal abnormality are detected.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: No spinal canal stenosis or neuroforaminal narrowing. C4-5: Posterior disc-osteophyte complex formation with mild to moderate spinal canal compromise and perhaps slight deformation of the spinal cord. Mild right foraminal narrowing. C5-6: Posterior disc-osteophyte complex formation with mild spinal canal compromise. Mild to moderate right foraminal narrowing. C6-7: Mild posterior disc-osteophyte complex formation. No significant spinal canal compromise. Moderate right and mild left foraminal narrowing. C7-T1: No spinal canal stenosis or neuroforaminal narrowing. Lumbar spine:The lumbar lordosis is straightened. There is a grade 1 anterolisthesis of L4 relative to L5. Vertebral body heights are preserved. Scattered degenerative endplate irregularity and Schmorl's node deformities are seen. No pathologic marrow replacement or edema is detected. Degenerative endplate signal change is noted at L4-5.The visualized distal spinal cord and conus are within normal limits. No epidural abnormalities are suspected.Multiple foci of apparent metallic artifact are seen along the posterior elements on the left at L4 and L5 suggesting the possibility of prior surgery.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: No significant spinal canal stenosis or neuroforaminal narrowing. L3-4: Mild facet arthropathy. No significant spinal canal stenosis or neuroforaminal narrowing. L4-5: Facet arthropathy with deformity along the left facet in particular. Bulging disc with a left paracentral/foraminal protrusion. The left lateral recess is effaced. The spinal canal is in general mildly narrowed. Moderate bilateral foraminal narrowing is seen. L5-S1: Facet arthropathy again with deformity along the left facet in particular. Bulging disc asymmetric to the right. No significant spinal canal stenosis. Severe right and moderate left foraminal narrowing.
1.No evidence of acute cord compression as assessed on the cord compression protocol examination.2.Posterior disc-osteophyte complex formation in the cervical spine resulting in spinal canal narrowing at C4-5 and C5-6. Scattered mild to moderate foraminal narrowing is also seen in the cervical spine.3.Findings are seen in the lumbar spine along the left posterior elements of L4 and L5 suggesting prior surgery. Correlation with surgical history is recommended.4.Disc degeneration and posterior element hypertrophy at L4-5 result in a mild spinal canal stenosis as well as moderate bilateral foraminal narrowing. Disc degeneration and posterior element hypertrophy at L5-S1 contribute to a severe right and moderate left foraminal narrowing.