Male, 59 years old, status-post spinal fusion with removal of C3 nerve root tumor. Assess for residual disease. Please note that a dedicated preoperative cervical spine MRI is not available for comparison. An enhancing lesion is partially visualized within the right C2-3 neural foramen on a prior brain MRI.Postoperative findings are seen compatible with a right C3 laminectomy. Instrumented spinal fusion has also been performed from C2 through C4 with bilateral lateral mass screws except on the right at C3. A fluid collection is present with blood fluid levels occupying the right C3 laminectomy bed tracking posteriorly. Another fluid collection is seen in the superficial subcutaneous tissues of the operative region.The right C2-3 neural foramen remains chronically widened. Nonspecific enhancing soft tissue is present within the foramen and extending into the right lateral aspect of the spinal canal where it seems to contact the lateral edge of the cord. The cervical lordosis is mildly straightened. Alignment is otherwise unremarkable. Marrow signal characteristics are mildly heterogeneous but with no evidence of concerning marrow replacement or marrow edema.The right lateral aspect of the spinal cord is slightly deformed at the level of the right C2-3 foramen which may indicate the effect of prior tumor or surgery. Elsewhere, the spinal cord is unremarkable. Extensive T2 hyperintensity is partially visualized in the pons.C2-3: Postoperative changes. No significant spinal canal stenosis. The left neural foramen is unremarkable. C3-4: Unremarkable. C4-5: Left uncovertebral hypertrophy. No significant spinal canal stenosis. The left neural foramen is mildly narrowed. C5-6: Posterior disk osteophyte formation. Facet hypertrophy. No significant spinal canal stenosis. Mild to moderate foraminal narrowing. C6-7: Posterior disk osteophyte formation asymmetric to the right. No significant spinal canal stenosis. Severe right and mild left foraminal narrowing. C7-T1: Posterior disk osteophyte formation asymmetric to the right. No significant spinal canal stenosis. Mild right foraminal narrowing. At T1-2 as visualized on the sagittal images, there is a bulging disk or disk protrusion with a left neural foramen causing moderate foraminal narrowing.
Postoperative findings are seen consistent with tumor resection from the right C2-3 neural foramen. There remains ill-defined enhancing soft tissue within the neural foramen which projects slightly into the adjacent right lateral spinal canal. The nature of this tissue is uncertain, particularly given the lack of dedicated comparison study, and could represent postoperative granulation, though the possibility of some residual tumor cannot be excluded. A fluid collection is present within the right C3 laminectomy bed as well as another within the more superficial subcutaneous tissues of the operative bed. These findings can be normal in the immediate postoperative state, but clinical and/or imaging follow-up is suggested to ensure resolution.