 CERVICAL: The patient is status post C2 -- T4 posterior fusion with bilateral pedicle screws and laminectomies at C3 -- T1 with susceptibility artifact from hardware limiting evaluation. There are immediate postoperative findings including edema and small fluid collection in the surgical bed. There are scattered foci of soft tissue gas consistent with immediate postsurgical change. There is improved anterolisthesis at C7-T1 which now measures up to 4 mm as compared 6 mm previously. There is persistent severe loss of intravertebral disk space, with endplate sclerosis and mild anterior wedging of T1 vertebral body. Again seen is moderate loss of height of the anterior T1 vertebral body and minimal loss of height involving the C7 vertebral body. There is significant improvement in the previously seen marked cervical spinal canal stenosis with the spinal canal now well decompressed from C3 to T1. There is abnormally increased T2 signal with mild expansion of the cord at the C7-T1 level which was present on preoperative study. THORACIC: There is susceptibility artifact from surgical hardware limiting evaluation of the levels to and including T4. There is no significant disk herniation, spinal canal or neural foraminal stenosis in the thoracic spine otherwise. The osseous marrow signal shows scattered foci of high T1 consistent with focal fatty deposition or hemangiomas. There is an isolated stable focus of low T1 signal and associated high T2 signal in the L1 vertebral body measuring up to 10 mm on series 14 image 4 which is nonspecific and may represent atypical hemangioma or other lesion.
1.Immediate postoperative findings related to laminectomies from C3 through T1 and C2 to T4 posterior fusion. Spinal canal is well decompressed. Hardware can be better evaluated with CT. Again seen is T2 cord signal abnormality at the C7-T1 level which was present preoperatively. 2.Improved 4-mm anterolisthesis at C7-T1 level compared 6 mm previously. Degenerative/destructive endplate changes at C7-T1 and compression fracture of T1 with differential considerations similar to prior exam.3.No epidural collection in the cervical or thoracic spine.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.