Inability to walk, which is worsened since July. Motion artifact does degrade image quality on multiple sequences.There is mild reversal of the normal cervical spine lordosis without evidence of acute subluxation. Multilevel degenerative changes are present throughout the cervical spine, worst at C3-C4 with mild impression on the ventral aspect of the cervical spinal cord. There is no definite abnormal signal in the cervical spinal cord. Significant spinal canal narrowing with cord compression and mild cord signal abnormality at T10-T11 appears similar to the exam from 7/1/2016. There are again findings compatible with discitis/osteomyelitis with loss of anterior vertebral body height more so at T11 than T10. There is been interval improvement of the paraspinal abscess. The abnormal vertebral body signal at T10 is resolved. Abnormal signal remains at the T10-T11 disc and anterior superior aspect of the T11 vertebral body. There is again resultant Minimal grade 1 anterolisthesis of L4 on L5. No high-grade lumbar spinal canal stenosis.
1. The degree of spinal stenosis and cord compression at T10-11 related to discitis/osteomyelitis appears grossly similar to the examination from 7/1/2016 with similar cord signal abnormality. 2. Improved paraspinal abscess and vertebral body edema. Motion artifact does degrade image quality.3. Multilevel degenerative changes in the cervical spine with stenosis and mild mass effect on the cord, worst at C3-C4, is similar to the degree seen on localizer imaging from the thoracic spine MRI dated 7/1/2016. 4. No definite abnormal signal in the cervical spinal cord. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine.Preliminary findings were discussed with Dr. Krupa Andalkar (neurosurgery) at 0755 hours on 8/4/2016.