Reason: eval for cord compression History: eval for cord compression Exam is limited by metal artifact from spinal fixation devices. There is evidence of anterior instrumented fusion at C3 and C4. Now seen is evidence of recent posterior decompression and fixation from C2 through C5. Thecal sac is expanded in the operative region with normal-appearing cord. However, at C2/3 level, above the decompression, there is kinking of the cord associated with left-sided, predominantly central cord T2 hyperintensity along with increased cord caliber. Multilevel disc desiccation is noted. Reversal of cervical lordosis is seen. Marrow signal is benign.T12/L1: No significant spinal canal stenosis or foraminal narrowing.C1/2: No significant spinal canal stenosis or foraminal narrowing.C2/3: Disc osteophyte formation with a small central disc protrusion. Kinking of the spinal cord with left-sided predominantly central cord signal abnormality with increased cord caliber. Moderate spinal canal stenosis. No significant foraminal narrowing.C3/4: Status post spinal canal decompression without obvious impingement of the cord. Mild to moderate bilateral foraminal narrowing.C4/5: Status post spinal canal decompression without obvious impingement of the cord. Posterior disc osteophyte complex noted. No significant foraminal narrowing.C5/6: Moderate to severe spinal canal stenosis. No cord signal abnormality. Moderate left and mild right foraminal narrowing.C6/7: Posterior disc osteophyte formation and ligamentum flavum thickening. Mild spinal canal narrowing. Moderate left and mild right foraminal narrowing.C7/T1: No significant spinal canal stenosis. Mild left foraminal narrowing from ligamentum flavum thickening.
1.Exam is limited by metal artifact from spinal fixation devices.2.Postsurgical changes of anterior spinal fixation at C3 and C4, and posterior decompression and fixation at C3, C4, and C5.3.Left sided, predominantly central spinal cord signal abnormality at the C2-3 level in association with spinal canal stenosis and mild kinking of the cord. The etiology for this finding is uncertain but it could represent compressive myelopathy.4.Multilevel degenerative changes of the cervical spine as above.