 There is abnormal increased T2 signal along the left side of the cervical spinal cord at the C3 and C4 levels. There also appears to be slight volume loss of the spinal cord in this region. There is redemonstration of changes related to C3-C7 laminectomies and posterior decompression with posterior stabilization rods and transpedicular screws bilaterally from C3 through C7. There is also bilateral facet joints fusion from C2-C3 to C7-T1. There is associated straightening of normal cervical lordosis. The vertebral body heights are preserved. There is no acute fracture identified. There is no current evidence of significant central canal stenosis. There is extensive ossification of the posterior longitudinal ligament extending from C3 to C6 vertebral bodies. There is moderate bilateral neural foraminal narrowing at C3-C4 and at least mild left and moderate right neural foramina narrowing at C4-C5. There also appears to be mild neural foraminal narrowing bilaterally at the remaining levels of the cervical spine; however, artifact from posterior fusion hardware limits evaluation. There is partially imaged low T1 and high T2 signal in the T2 spinous process and right T2 and T2 pedicles and facet joint.
1. Increased T2 signal within the left side of the spinal cord at the C3-C4 level. Given that there appears to be mild volume loss, this likely relates to myelomalacia. Spinel cord contusion, ischemia, or inflammatory/infectious etiology are considered less likely. 2. Postoperative findings related to C3-C7 posterior fusion and laminectomies. However, artifact from the surgical hardware again limits evaluation.3. Extensive ossification of posterior longitudinal ligament extending from C3 to C6 vertebral bodies with mild to moderate multilevel neural foraminal stenoses.4. Partially imaged low T1 and high T2 signal in the T2 spinous process and right T2 and T2 pedicles and facet joint may represent an infectious or inflammatory process. However, assessment is limited without contrast and follow up with dedicated thoracic spine MRI may be useful.