Reason: Left arm weakness History: Left arm weakness The exam is limited by patient motion.The cervical vertebral bodies are appropriate in overall alignment and height. The patient is status post recent laminectomies and posterior fusion with facet screws and at C2, C3 and C4. Previously noted spinal stenosis at C2-3, C3-4 and C4-5 has been alleviated.The patient has a focal signal hyperintensity at the C3-4 involving predominantly the spinal cord centrally - left more than right. Comparing to the prior exam it appears to have been previously present to some degree (see images 11 on series #4 and #7 of the prior exam) but may have been obscured by the severe spinal stenosis.Detailed evaluation of he neural foramina is partly obscured by patient motion. There are disk bulges present at C3-4, C4-5 , C5-6 associated with loss of disk space height and disk dessication. Bilateral neural foramen encroachment of exiting nerve roots is present at C3-4.The vertebral artery flow voids appear to be intact.
1.Since the prior exam the patient has undergone multilevel laminectomies and posterior fusion in the upper cervical spine.2.A central spinal cord abnormality at C3-4 eccentric to the left hemicord is more obvious on the current exam. The possibility of progression of edema cannot be excluded. Most likely this is related to spondylitic myelopathy status post decompression. It is conceivable that there is new superimposed injury. Please correlate with clinical exam findings.3.Exam is limited by patient motion which can obscure more subtle abnormalities and changes. The patient was not able to tolerate more imaging.