Findings
Cervical spine - There are postsurgical changes of anterior fusion at C5 and C6. There is possible small area of T2 change in the cord at this level suggesting a small area of myelomalacia. Thercervical discs show loss of T2 weighted signal suggesting degenerated discs. The ovoid lesion in the posterior neck subcutaneous fat at about the Z6/C7 level is again seen and measures about 1.8 X 1.3 X 1.7 cm and shows high signal on T1 - weighted and slightly lower signal on T2 weighted images. This lesion likely represents a lipoma.
From the foramen magnum through C2/C3 there is no significant central canal stenosis.
At C2/C3 there is disc-osteophyte complex causing mild right neuroforaminal and no significant central canal or left neuroforaminal stenosis.
At C3/C4 there is disc-osteophyte complex causing moderate central canal and moderate bilateral neuroforaminal stenosis.
At C4/C5 there is disc-osteophyte complex causing severe central canal and severe bilateral neuroforaminal stenosis.
At C5/C6 there is disc-osteophyte complex causing mild spinal stenosis with moderate foraminal stenosis.
At C6/C7 there is disc-osteophyte complex causing severe central canal and severe bilaterial neuroforaminal stenosis.
At C7/T1 there is disc-osteophyte complex causing no signaficant central canal and moderate bilaterial neuroforaminal stenosis.
At the C4/C5 through C6/C7 levels but may be on a T2 weighted siginal suggesting cord edema.
Thoracic Spine-the thoracic vertebral bodies show normal height, alignment, and signal. The conus medullaris terminates at about T12/L1. The thoracic spinal cord shows normal signal and size. The spinal canal is normally smaller than average, however no significant central canal or neuroforaminal stenosis is identified. The thoracic discs show normal height and signal. No paraspinal mass is visualized. Innumerable liver and bilateral renal cysts are again seen and consistent with patient's known autosomal dominant polycystic disease
Impression
1. Anterior cervical spinal fusion at C5 and C6. There is possible small area of T2 change in the cord at this level suggesting a small area of myelomalacia. There is moderate to severe cervical spine disease that is predominant at C3/C4 C4/C5, and C6/C7 with spinal stenosis. Please see above.
2. Unremarkable precontrast thoracic spine MR.
3. Multiple liver and bilateral renal cysts are compatible with patient's known autosomal dominant polycystic disease.
