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Spinal Cord Disorders Message Board


Spinal Cord Disorders Board Index


CLINICAL HISTORY: scoliosis; daily numbness in bilateral upper extremities
 737.30 - Scoliosis (and kyphoscoliosis), idiopathic
numbness in bilateral upper extremities 

COMPARISON:

TECHNIQUE: MR CERVICAL SPINE WO CONTRAST, MR THORACIC SPINE WO CONTRAST,
MR LUMBAR SPINE WO CONTRAST

FINDINGS:

CERVICAL SPINE: The vertebral body heights and disk spaces are maintained.
Straightening of the normal cervical spine lordosis is likely related to
position. There is no abnormal spinal cord signal. No acute abnormalities
in the included paraspinal soft tissues or posterior fossa. No dysraphism
or segmentation anomalies.

Axial images:

C2-C4: Scattered disk osteophyte complexes posteriorly without significant
spinal canal or neuroforaminal stenosis.

C4-C5: Posterior disk osteophyte complex which causes mild spinal canal
stenosis. No significant neuroforaminal stenosis.

C5-C6: Posterior disk osteophyte complex without significant spinal canal
stenosis. There is mild left neuroforaminal stenosis. No right
neuroforamina stenosis.

C6-T1: No significant spinal canal or neuroforaminal stenosis.

THORACIC SPINE:

There is redemonstration of the S-shaped thoracolumbar scoliosis which is
better delineated on the radiographs from 7/10/14. The vertebral body
heights are fairly well maintained. There are no segmentation anomalies.
There are areas of multilevel disk desiccation.

Axial images:

T1-T9: No significant spinal canal or neuroforaminal stenosis.

T9-T10: There is left facet hypertrophy with mild to moderate
neuroforaminal stenosis. No significant central canal or right
neuroforaminal stenosis.

T10-T11: There is left facet hypertrophy with mild lateral recess stenosis
and moderate left neuroforaminal stenosis.

T11-T12: Bilateral facet hypertrophy and mild right eccentric location of
the spinal cord. There is mild left neuroforaminal stenosis. However, no
significant spinal canal or right neuroforaminal stenosis.

There is an eccentric location at multiple levels of the spinal cord
within the thecal sac. However, there is no abnormal spinal cord signal.

There are small bilateral pleural effusions.

LUMBAR SPINE:

Again, the left apex scoliosis is redemonstrated and better delineated on
the radiographs from 7/10/14. The vertebral body heights are maintained.
There is multilevel disk desiccation most notably at L4-L5 and T12-L2.
There is no dysraphism or segmentation anomalies.  There is an incidental
fibrolipoma of the filum terminale with no cord tethering.  Conus
medullaris terminates normally at L1.

There appears to be a small incompletely detailed cyst in the right
kidney. No acute abnormalities in the included abdomen, pelvis or
paraspinal soft tissues.

Axial images:

T12-L1: The spinal cord and nerve roots are located eccentrically within
the right lateral recess/foramenal region where there is mild to moderate
stenosis from facet hypertrophy. There is mild right neuroforaminal
stenosis. No significant spinal canal stenosis.

L1-L2: The nerve roots are located eccentrically within the right lateral
recess which is moderately narrowed from a circumferential disk bulge and
right facet hypertrophy. There is mild spinal canal stenosis and mild
right neuroforaminal stenosis.

L2-L3: Multiple nerve roots remain in the right lateral recess and there
is mild spinal canal stenosis from a circumferential disk bulge and
bilateral facet hypertrophy. No significant neuroforaminal stenosis.

L3-L4: There is mild spinal canal stenosis from a mild disk bulge and
facet hypertrophy. There is no significant spinal canal or neuroforaminal
stenosis. However, the right exiting nerve exits inferiorly within the
right neuroforaminal where there is minimal impingement.

L4- L5: There is no significant spinal canal or neuroforaminal stenosis.
However, the right exiting nerve exits inferiorly where there is moderate
impingement.

L5-S1: No significant spinal canal or neuroforaminal stenosis.

IMPRESSION:

If posterior hardware is being contemplated, close attention to multiple
levels where the cord and nerve roots extend into the foramen and lateral
recess is recommended.

Redemonstration of the S-shaped thoracolumbar scoliosis which is better
delineated on the radiographs from 7/10/14. No segmentation anomalies or
dysraphism.

There is eccentric location of the spinal cord and nerve roots at multiple
levels most prominent in the upper lumbar spine where the distal spinal
cord and nerve roots are located within the right lateral recess and
partially extend into the neuroforamen at L1-L2. 

No abnormal spinal cord signal.

No significant spinal canal or neuroforaminal stenosis in the cervical
spine.

Varying degrees of neural foraminal and spinal canal stenosis in the
thoracic and lumbar spine as detailed above.

Small bilateral pleural effusions.





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