FINDINGS:
The vertebral bodies were numbered starting from the
craniocervical junction. Per convention, there are 7 cervical, 12
thoracic, and 5 lumbar vertebrae for the purposes of numbering in
this dictation. The right transverse process of L5 is broadened
with a pseudoarticulation between the transverse process and the
sacrum and the left transverse process of L5 is not broadened or
sacralized, consistent with partial sacralization of L5.
There is osseous fusion of the C5-C7 vertebral bodies. The
pedicles are congenitally short from C3-C6. Multilevel disc
desiccation. Moderate narrowing of the C4-5 intervertebral disc.
Mild narrowing of the C7-T1 intervertebral disc. Moderate to
severe multilevel disc space narrowing in the thoracic spine
which is most pronounced at T6-7. Degenerative endplate changes
at T6-7. The intervertebral disc spaces are within normal limits
in the lumbar spine. Multilevel disc desiccation in the lumbar
spine. Mild anterior wedging of the T10 and T11 vertebral bodies
which may be related to mild remote vertebral compression
fractures or physiologic variation. Multilevel Schmorl’s nodes. 2
mm of retrolisthesis of C4 on C5. Multilevel uncinate spurring in
the cervical spine. The spinal cord is within normal limits in
caliber and signal. The conus medullaris terminates at the level
of L1-2. Mild to moderate multilevel degenerative changes of the
facets. The main pulmonary is enlarged which is nonspecific but
raises the possibility of pulmonary artery hypertension. Cysts
are partially visualized in the kidneys. The liver measures 18.5
cm in the craniocaudal dimension, consistent with mild
hepatomegaly. A 2.2 cm nodule in the right adrenal gland is
unchanged from the CT of the chest dated 04/01/2021 and is
consistent with an adrenal adenoma. Mild atrophy of the bilateral
posterior paraspinal musculature.
On axial images:
At C2-3, the posterior margin of the disc is normal. The thecal
sac is patent. Mild bilateral neural foraminal narrowing.
At C3-4, small disc osteophyte complex. Buckling of the
ligamentum flavum. The thecal sac measures 9 mm in midline AP
dimension. Both lateral recesses are mildly narrowed. Moderate to
severe bilateral neural foraminal narrowing.
At C4-5, moderate disc osteophyte complex which is eccentric in
the left paracentral region. The thecal sac measures 7 mm in
midline AP dimension. Both lateral recesses are narrowed, left
greater than right. Moderate to severe bilateral neural foraminal
narrowing.
At C5-6, osseous fusion of the C5 and C6 vertebral bodies is
noted. Bone along the expected posterior margin of the disc
protrudes in the left paracentral region. The thecal sac measures
10.5 mm in midline AP dimension. Mild to moderate right neural
foraminal narrowing. Moderate left neural foraminal narrowing.
At C6-7, osseous fusion of the C6 and C7 vertebral bodies. Bone
along the expected posterior margin of the disc protrudes in the
central/left paracentral region. The thecal sac measures 10.5 mm
in midline AP dimension. Patent right neural foramen. Mild left
neural foraminal narrowing.
At C7-T1, the posterior margin of the disc is normal. The thecal
sac is patent. Mild right neural foraminal narrowing. Moderate
left neural foraminal narrowing.
At T1-2, the posterior margin of the disc is normal. The thecal
sac is patent. Mild to moderate bilateral neural foraminal
narrowing.
At T2-3, mild diffuse annular disc bulge. The thecal sac measures
11.5 mm in midline AP dimension. Mild right neural foraminal
narrowing. Mild to moderate left neural foraminal narrowing.
At T3-4, small disc osteophyte complex. The thecal sac measures
12.5 mm in midline AP dimension. Mild right neural foraminal
narrowing. Patent left neural foramen.
At T4-5, small diffuse annular disc bulge. The thecal sac
measures 12 mm in midline AP dimension. Mild right neural
foraminal narrowing. Patent left neural foramen.
At T5-6, small disc osteophyte complex. The thecal sac measures
12 mm in midline AP dimension. Patent right neural foramen.
Patent left neural foramen.
At T6-7, moderate disc osteophyte complex. The thecal sac
measures 9.5 mm in midline AP dimension. Mild right neural
foraminal narrowing. Mild to moderate left neural foraminal
narrowing.
At T7-8, mild diffuse annular disc bulge. The thecal sac measures
12 mm in midline AP dimension. Mild right neural foraminal
narrowing. Minimal left neural foraminal narrowing.
At T8-9, mild diffuse annular disc bulge. The thecal sac measures
12 mm in midline AP dimension. Minimal right neural foraminal
narrowing. Moderate left neural foraminal narrowing. 5 mm T2
markedly hyperintense lesion in the right neural foramen, likely
representing a perineural cyst.
At T9-10, the posterior margin of the disc is normal. The thecal
sac is patent. Mild bilateral neural foraminal narrowing. 5 mm T2
markedly hyperintense lesion in the right neural foramen, likely
representing a perineural cyst.
At T10-11, small disc osteophyte complex. The thecal sac measures
11.5 mm in midline AP dimension. Mild bilateral neural foraminal
narrowing.
At T11-12, mild diffuse annular disc bulge. The thecal sac
measures 12 mm in midline AP dimension. Mild bilateral neural
foraminal narrowing.
At T12-L1, the posterior margin of the disc is normal. The thecal
sac is patent. Patent neural foramina.
At L1-2, minimal diffuse annular disc bulge. The thecal sac
measures 10.5 mm in midline AP dimension. Patent right neural
foramen. Mild left neural foraminal narrowing.
At L2-3, the posterior margin of the disc is normal. The thecal
sac measures 10.5-11 mm in midline AP dimension. Mild bilateral
neural foraminal narrowing.
At L3-4, minimal diffuse annular disc bulge. The thecal sac
measures 12 mm in midline AP dimension. Mild bilateral neural
foraminal narrowing.
At L4-5, small disc osteophyte complex. The thecal sac measures
12.5 mm in midline AP dimension. Both lateral recesses are
narrowed, left greater than right. The disc osteophyte complex
comes in very close proximity to and may possibly contact the
descending left L5 nerve root (series 5, image 9). Mild to
moderate bilateral neural foraminal narrowing.
At L5-S1, small disc osteophyte complex. The thecal sac measures
11 mm in midline AP dimension (series 5, image 5). Patent right
neural foramen. Mild left neural foraminal narrowing.
Impression:
Partial sacralization of L5. Please see the body of the report
for the numbering convention used in this report.
The pedicles are congenitally short from C3-C6.
Osseous fusion of the C5-C7 vertebral bodies.
Multilevel degenerative disc disease.
Mild spinal stenosis at C3-4.
Moderate spinal stenosis at C4-5.
Mild spinal stenosis at T6-7.
At L4-5, the disc osteophyte complex comes in very close
proximity to and may possibly contact the descending left L5
nerve root.
Multilevel neural foraminal narrowing as discussed above. Please
note that there is significant multilevel neural foraminal
narrowing.
Mild to moderate multilevel degenerative changes of the facets.
2 mm of retrolisthesis of C4 on C5.
Mild anterior wedging of the T10 and T11 vertebral bodies which
may be related to mild remote vertebral compression fractures or
physiologic variation.
The main pulmonary is enlarged which is nonspecific but raises
the possibility of pulmonary artery hypertension.
Mild hepatomegaly.
They called me wanting to know IF I’d be agreeable to a Pain Clinic visit before I had even seen the above report. They must see something that causes them to make the offer.
I am certainly open to it! Especially since they’re discounting Chiropractic Care outright!
I’m going to bring this report to my Chiropractor and see if they agree with that determination.