Reason: r/o cord compression History: back pain. Acute onset saddle anesthesia and urinary incontinence. Cervical spine:The patient is status post anterior fusion at C5, C6 and C7. The exam is degraded by patient motion artifact.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is disk desiccation and some endplate osteophytes as well as a disk bulge at this level. Since the prior exam there has been regression of the spinal stenosis at this level.At C3-4 there is diffuse disk bulge associated with posterior ligamentous hypertrophy and effacement of spinal fluid ventral and posterior to spinal cord creating a moderate degree of spinal stenosis. This is stable compared to the prior exam.At C4-5 there is central disk protrusion associated with effacement of spinal fluid ventral and posterior to spinal cord creating a moderate degree of spinal stenosis. Since the prior exam there has been regression of the spinal stenosis at this level.At C5-6 there is no significant compromise to the spinal canal or neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal. There is some narrowing of the neural foramina due to disk material at this level. Compared to the prior exam there is been some improvement in the spinal stenosis at this level.The vertebral artery flow voids appear to be intact.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. The exam is degraded by patient motion artifact.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is facet hypertrophy present at this level, disk desiccation and a disk bulge. There is narrowing of the neural foramina at this level left worse than right. Compared to prior exam this is stableAt L4-5 there is loss of disk space height, disk desiccation, diffuse disk bulge and bilateral facet and ligamentum flavum hypertrophy associated with mild anterior subluxation of L4 and L5. Overall there is a moderate degree of spinal stenosis at this level. Additionally there is partial effacement of fat within the neural foramina bilaterally with mild encroachment of the exiting nerve roots within the neural foramina. When compared to the previous exam there does not appear to be any significant change.At L3-4 there is loss of disk space height, disk desiccation, diffuse disk bulge and bilateral facet and ligamentum flavum hypertrophy . Overall there is a moderate to severe degree of spinal stenosis at this level. Additionally there is partial effacement of fat within the neural foramina bilaterally with mild encroachment of the exiting nerve roots within the neural foramina. When compared to the previous exam there does not appear to be any significant change.At L2-3 there is loss of disk space height, disk desiccation and disk bulge associated with some facet and ligamentum flavum hypertrophy. Overall there is a mild to moderate degree of spinal stenosis at this levelAt L1-2 there is no significant compromise to spinal canal or neural foramina.Are multiple large renal cysts present. These were also present on the October exam as well and not substantially different
1.The exams are degraded by motion artifact which can obscure more subtle abnormalities or more subtle changes.2.There are multilevel degenerative changes present in the cervical spine resulting in multilevel spinal stenosis. Within the cervical spine spinal stenosis at that C2-3, C4-5 and C7-T1 has improved whereas spinal stenosis at see C3-4 remains relatively stable when compared to 7/25/11.3.There are multilevel degenerative changes are present in the lumbar spine resulting in spinal stenosis at L2-3, L3-4 and L4-5 worse at L3-4. This is stable when compared to the prior exam of 10/20/14.