Evaluate etiology of left arm pain and paresthesias, numbness and tingling in left forearm and thumb Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate height. Alignment is maintained. Bone marrow signal is benign. Again seen are multilevel degenerative changes in the cervical spine which are minimally progressed since 5/8/2013. There is minimal interval increase in endplate marrow signal changes at C6 and C7.The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is uncovertebral hypertrophy on the right resulting in mild right neural foraminal narrowing. No significant spinal canal or left neural foraminal stenosis.C4-5: No significant compromise to the spinal canal. Minimal bilateral neural foraminal narrowing related to mild uncovertebral hypertrophy.C5-6: There is disk osteophyte complex and ligamentum flavum thickening with resulting mild spinal canal stenosis at this level. There is moderate to severe bilateral neural foraminal stenosis related to uncovertebral hypertrophy.C6-7: There is disk osteophyte complex and ligamentum flavum thickening with resulting mild spinal canal stenosis at this level. No evidence of cord compression or cord signal abnormality. There is moderate bilateral neural foraminal stenosis related to uncovertebral hypertrophy.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Degenerative changes in the cervical spine are minimally progressed compared to 5/8/2013. Again seen are disk osteophyte complexes with uncovertebral hypertrophy at C5-C6 and C6-C7 with moderate to severe neural foramina stenosis at C5-C6 and moderate neural foramina stenosis at C6-C7 bilaterally. There may be impingement of the exiting C6 and C7 nerve roots, respectively.2. No significant change in mild spinal canal stenosis at C5-C6 and C6-C7 without evidence of cord compression or cord signal abnormality.