Rcpd0715

****I am sorry if this shows up a bunch of times, for some reason it keeps disappearing****

I wanted to also show the rest of the results of the two MRIs I had to see if you had any opinions on them. If you don’t mind of course. I really appreciate you being so helpful to so many people!

Lumbar:

Noncontrast MRI of the lumbar spine, 3/31/2021 9:56 PM

History: Chronic right lower back pain with ipsilateral sciatica

Technique: Sagittal STIR, T2, T1, and axial T2 and T1 sequences

Comparison: None currently available

FINDINGS:

There are 5 lumbar type vertebrae. The conus medullaris terminates at the level of the upper margin of L2. A minute filum terminale fibrolipoma is incidentally noted.

There is no discernible MRI evidence of fracture, compression deformity, or dislocation. The spinal alignment, bone marrow signal, and paraspinal soft tissues are unremarkable.

T12-L1 (above the level of the axial images): The disc height and signal are maintained. The spinal canal and neural foramina are widely patent.

L1-L2, L2-L3, and L3-L4: The disc heights and signals are maintained. The spinal canal and neural foramina are widely patent at each level.

L4-L5: There is a prominent posterior annular tear. Disc height and signal are otherwise maintained. The facet joints are slightly hypertrophied. There are trace facet joint effusions. There is mild spurring marginating the disc space. The spinal canal is widely patent. There is mild to moderate right-sided and mild left-sided bony narrowing of the neural foramina anteroinferiorly without evidence of foraminal impingement.

L5-S1: There is moderate to advanced narrowing along the canalicular margin of the disc space. The disc space is otherwise only minimally narrowed. Disc signal is diminished. There is a posterior annular tear. A broad mild spur-disc complex does not significantly compromise the spinal canal. The facet joints are slightly hypertrophied. There is a trace right-sided facet joint effusion. There is moderate spurring along the left side of the disc space and mild spurring along the right side of the disc space. There is moderate left-sided and mild right-sided bony narrowing between (a) the L5 pedicle to transverse process transitions superiorly and (b) subjacent L5 vertebral body disc space marginal osteophytes; the exiting left-sided nerve is deflected/elevated.

The included portion of the sacrum is unremarkable.

IMPRESSION:

Mild lower lumbar spondylotic/discogenic changes (level-by-level basis)

Cervical:

Noncontrast MRI of the cervical spine, 3/31/2021 9:55 PM

History: Cervical canal stenosis

Technique: Sagittal STIR, T2, T1, coronal T2, and axial T2 (turbo spin echo and medic) and T1 sequences

Comparison: None currently available

FINDINGS:

There is no discernible MRI evidence of fracture, compression deformity, or dislocation. The paraspinal soft tissues, spinal alignment, cervicomedullary junction, and cord signal are unremarkable. The moderate generalized marrow hypointensity on the T1-weighted sequences likely pertains to hematopoietic elements (red marrow), an expected finding in this age group.

C2-C3: (Attention is directed to this level) There is moderate to advanced narrowing along the anterior margin and posterior 1/4 of the disc space. There is mild narrowing of the remainder of the disc space. There is a prominent broad spur-disc complex. This abuts and impresses upon the cord. There is moderate left-sided and mild right-sided canalicular stenosis with commensurate degrees of cord flattening. Although there is at least as yet no overt/robust cord signal abnormality, such could potentially ensue — particularly on the left (consequent to compression-induced ischemia and subsequent myelomalacia). There is moderate to advanced left-sided and moderate right-sided narrowing of the neural foramina due to uncovertebral and facet joint hypertrophy.

C3-C4: There is focal advanced narrowing along the anterior margin of the disc space and mild to moderate narrowing along the posterior margin of the disc space. There is a broad spur-disc complex. The ventral aspect of the CSF space is partially effaced, but there is no overt canalicular stenosis. There is moderate narrowing of the neural foramina due to uncovertebral and facet joint hypertrophy.

C4-C5: There is focally advanced narrowing along the anterior margin of the disc space and moderate to advanced narrowing along the posterior margin of the disc space. There is a broad spur-disc complex, larger toward the right. The ventral aspect of the CSF space is partially effaced, but there is no overt canalicular stenosis. There is moderate to advanced narrowing of the right neural foramen due to uncovertebral and to a lesser extent facet joint hypertrophy. The left neural foramen is widely patent.

C5-C6: The right ventral aspect of the CSF space is partially effaced due to ipsilateral uncovertebral hypertrophy, but there is no overt canalicular stenosis. There is mild to moderate narrowing of the right neural foramen due to the aforementioned uncovertebral joint hypertrophy. The left neural foramen is widely patent.

C6-C7: There is moderate to advanced narrowing along the posterior margin of the disc space. There is mild narrowing of the remainder of the disc space. There is a broad spur-disc complex, largest in the left paramidline region. The ventral aspect of the CSF space is largely effaced, but there is no overt canalicular stenosis. There is mild to moderate narrowing of the neural foramina due to uncovertebral joint hypertrophy.

C7-T1: There is focal mild narrowing along the posterior margin of the disc space. There is a mild to moderate left paramidline spur-disc complex. This contacts the ventral surface of the cord. The canal is not overtly stenotic. Foraminal patency is adequate on each side.

IMPRESSION:

Spondylotic/discogenic changes (level-by-level basis) — attention is directed to the C2-C3 level

Again, Thank you for all that you do! You are a blessing to those in need!