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CT C-spine Degen

Technique: Axial images of the cervical spine obtained with sagittal and coronal reconstruction. No contrast was given. Findings: There is normal osseous alignment without fracture or subluxation. There is multilevel degenerative changes consisting of disc space narrowing, endplate, uncinate and facet osteophytosis more pronounced in the lower levels. There is no evidence of spinal canal stenosis. The paravertebral soft tissues are normal. Impression: 1. No cervical spine fracture. 2. Multilevel degenerative changes, as above. ------------------------------------------------------------------------------- Technique: Axial images of the cervical spine obtained with sagittal and coronal reconstructions. No contrast given. Findings: There is normal osseous alignment without fracture or subluxation. The previously demonstrated curvilinear osseous density at the anteroinferior margin of the sixth cervical vertebra follows the contour of the anteriorly bulging C6-C7 disc, compatible with disc osteophyte complex. The right transverse process of T1 is separate from the vertebral body. This may be congenital or the sequela of remote trauma. The margins are sclerotic. There is mild multilevel disc height loss, endplate degenerative change, and posterior disc osteophyte complexes, most notably at the C5-C6 level. There is no significant spinal canal or neural foraminal stenosis. The skull base is normal. The prevertebral soft tissues as well as the remaining soft tissues of the neck are unremarkable. Impression: Degenerative changes of the cervical spine without fracture or subluxation. --------------------------------------------------------------------------------------------- TECHNIQUE: Routine transverse thin section CT images from skull base to thoracic inlet without contrast. FINDINGS: There is multilevel bulky flowing anterior osteophytosis with anterior fusion at C4-C5 and C5-6, pronounced disc height loss with vacuum phenomenon and disc space fusion. There is pronounced facet arthrosis. There is otherwise normal cervical alignment. There is multilevel loss of vertebral body height most prominent within the mid cervical area. The spinal canal and neural foramen are patent without pathologic stenosis. There is no fracture or subluxation. There is chunky calcification within the bilateral carotid bifurcation suggestive of atherosclerotic disease. IMPRESSION: 1. No fracture or subluxation. 2. Pronounced multilevel degenerative change with bulky flowing anterior osteophytosis and disc space fusion, and pronounced facet arthrosis. 3. Evidence of ASVD and the carotid bifurcation regions. --------------------------------------------------------------------------------------------- Technique: Axial images of the cervical spine obtained with sagittal and coronal reconstructions. No contrast given. FINDINGS: Limited images of the paracervical soft tissues are unremarkable. Sagittal and coronal reconstruction demonstrate a small accessory ossicle arising of the C7 spinous process. Appearance does not represent a Clay shovelers type fracture. C2-C3: No spinal stenosis. Foramina are patent bilaterally. C3-C4: No spinal stenosis. Foramina are patent bilaterally. C4-C5: Mild disc space narrowing due to degenerative disc disease. No spinal stenosis. Foramina are patent bilaterally. C5-C6: Disc space narrowing due to degenerative disc disease disease. Bilateral foraminal narrowing due to uncovertebral joint hypertrophy. C6-C7: No spinal stenosis. Foramina are patent bilaterally. C7-T1: No spinal stenosis. Foramina are patent bilaterally IMPRESSION: 1. At C5-C6, there is bilateral foraminal narrowing due to uncovertebral joint hypertrophy. 2. Multilevel degenerative disc disease at within the cervical spine as noted above. 3. At C7, there is accessory ossicle arising off the tip of the spinous process. This does not represent a Clay shovelers fracture --------------------------------------------------------------------------------------------- Findings: There is straightening of the normal cervical lordosis, most likely related to patient positioning and placement in a cervical collar. There is no acute fracture or subluxation of the spinal elements. Multilevel degenerative changes are noted throughout the cervical spine, most prominent at the C5-C6 and C6-C7 levels. Uncovertebral hypertrophy results in mild right-sided neural foraminal narrowing at C4-C5 and C5-C6; which is not significantly changed from prior. There is no spinal canal stenosis. The linear calcification anterior to the C6 vertebral body is unchanged in appearance. The atlanto-occipital and atlantoaxial articulations are intact. The prevertebral soft tissues are normal. A calcified nodule in the right thyroid lobe is unchanged in size and appearance. The visualized portions of lung apices and calvarium demonstrate no gross abnormalities. --------------------------------------------------------------------------------------------- TECHNIQUE: Thin section transverse CT images were obtained from skull base to the thoracic inlet in spine field-of-view. The image set was reformatted in sagittal plane. FINDINGS: Alignment: Within normal limits. There is straightening of cervical lordosis. Vertebral body heights: Within normal limits. Craniocervical junction: Within normal limits. Disc levels: C2-C3: Normal. C3-C4: Near complete degenerative disc height loss, with minimal posterior disc bulging. Mild left uncinate hypertrophy. No significant spinal canal or neural foramen stenosis. C4-C5: Near complete degenerative disc height loss with posterior disc protrusion and endplate osteophytosis and right uncinate hypertrophy, which cause mild to moderate spinal canal and moderate right neural foramen stenosis. C5-C6: Near complete degenerative disc height loss worst right of midline, circumferential disc bulging, endplate and right worse on left bilateral uncinate hypertrophy. These findings cause mild to moderate spinal canal and mild right neural foramen stenosis. C6-C7: Near complete degenerative disc height loss worst right of midline, circumferential disc bulging, and right worse on left uncinate hypertrophy, which cause mild spinal canal but severe right neural foramen stenosis. There is minimal left neural foramen narrowing. C7-T1: Normal. Other: No acute or aggressive osseous lesion. Limited views of the paraspinal soft tissues are unremarkable. IMPRESSION: Multilevel degenerative disc-osteophytic disease with significant disc height loss causing mild to moderate spinal canal and moderate right neural foramen stenosis, worst in the lower cervical levels, as described in detail by levels above. Note: Most patients can have MRIs after spinal instrumentation such as this patient's. Correlation with written data on the specific spinal fusion hardware used, such as operative reports, may be helpful. MRI images may be blurred in the region of the hardware, especially if it is stainless steel, which are the original Harrington rods and many of the older systems used. In contrast, pacemakers, spinal cord stimulator and intrathecal pumps are contraindications to MRI. Certain metal clips in the brain, any metal fragments in the eyes and in other vital organs may also be contraindicated. Therefore, the requesting health care provider and the patient should discuss these in the context of her medical history and complaints, especially if surgery is contemplated. --------------------------------------------------------------------------------------------- Findings: There is normal osseous alignment without fracture or subluxation. The vertebral body heights are preserved. There is multilevel disc height loss, endplate and uncovertebral hypertrophic change, worse at the C5-C6 level. There is moderate to severe right neural foraminal stenosis at C5-C6. There is mild variable spinal canal stenosis. There is a 4 mm lytic lesion in the C3 vertebral body. This is a nonspecific finding however given the patient's underlying metastatic process, a focal osseous metastasis cannot be excluded. There is a well-circumscribed fluid-density cystic lesion in the right thyroid lobe, measuring 1.9 cm. There is a coarsely calcified thyroid nodule measuring approximately 1.2 cm, located at the inferior margin of the right thyroid lobe. There are coarse calcifications in the left thyroid lobe. There is aneurysmal dilatation of the right subclavian artery. Atherosclerotic calcifications are seen throughout the aorta and its branches. There is a 3 mm calcified granuloma in the superior segment of the left lower lobe. Impression: No evidence of cervical spine fracture. Numerous additional findings as above.