Fibromyalgia

OA, Symptomatic RA

SI Joint Disfunction

Displacement of lumbar intervertebral disc without myelopathy

DDD (degenerative disc disease), cervical

Neuropathic pain

Other chronic pain

Polyarthralgia

Failed back surgical syndrome

Facet arthropathy, cervical

Cervical radicular pain

Complaints of total body pain

Neuropathy

Thoracic radiculopathy

Cervical stenosis of spine

Lumbar radiculopathy

Cervical radiculopathy

Vitamin B12 deficiency

Past use of tobacco

Verbal Memory Impairment difficulties

Vitamin D deficiency

Essential hypertension

Presence of intrathecal pump

Dream enactment behavior

Excessive daytime sleepiness

Complexed sleep apnea
BiPap

TMJ Dysfunction

HNP (herniated nucleus pulposus), thoracic

DISH (diffuse idiopathic skeletal hyperostosis)

Environmental and seasonal allergies

The cervical spinal canal is congenitally small which is likely related to
congenitally short pedicles. There is loss of the usual cervical lordosis with
straightening of the cervical spine. There is approximately 2 mm
retrolisthesis of C6 on C7. The cervical vertebral body heights are
maintained. Generalized bone marrow signal is within normal limits for age.

The cervical spinal cord is normal in caliber and signal. The cerebellar
tonsils are normal in position.

C2-C3: The disc is within normal limits. The central canal and left foramen
are patent. There is mild right foraminal narrowing secondary to mild right
facet arthropathy.

C3-C4: Unremarkable.

C4-C5: There is a shallow right paracentral disc protrusion. Mild uncinate
hypertrophy and mild facet arthropathy contribute to mild left and minimal
right foraminal stenosis. The central canal is patent.

C5-C6: There is a shallow left paracentral disc protrusion, superimposed on a
small disc bulge osteophyte complex. Endplate osseous ridging is seen along
with very minimal facet arthropathy. Moderate left and mild right foraminal
stenosis is present. The central canal is small but patent.

C6-C7: There is a diffuse disc bulge osteophyte complex with shallow left
foraminal disc protrusion noted. Mild facet arthropathy and endplate osseous
ridging contributes to moderate left foraminal stenosis. Mild to moderate
right foraminal stenosis is also seen. The central canal is small but patent.

C7-T1: The disc is within normal limits. There is mild facet arthropathy on
the left and mild to moderate facet arthropathy on the right. The central
canal and foramen are patent.
The T1-2, T2-3, T3-4 and T4-5 discs are within normal limits. At these levels,
there is no significant central canal or foraminal stenosis.

T5-6: There is a broad-based left paracentral disc protrusion which extends
slightly into the left neural foramen. The central canal is patent. There is
mild narrowing of the left lateral recess and left neural foramen. This disc
is slightly larger than on the prior study.

T6-7: There is a right paracentral minimally cranially and minimally caudally
extruded disc herniation, larger than on the prior study. Mild effacement of
the right ventral thecal sac and ventral surface of the spinal cord is
observed but there is no abnormal cord signal. No significant foraminal
stenosis seen.

T7-8: There is a shallow posterior central disc protrusion, unchanged compared
to the prior study. The central canal and foramen are patent.

T9 and T9-10: Minimal disc bulges are seen. The central canal and foramen are
patent as imaged.

T10-11: There is significant metallic artifact limiting assessment of the disc
space. There is suggestion of a small disc bulge.

T11-12 and T12-L1: Unremarkable.

T11-T12: Metallic susceptibility artifact related to right-sided pedicle
screws are again seen. There is suggestion of a persistent diffuse disc bulge
and small focal left paracentral disc extrusion which contributes to mild
partial effacement of subarachnoid space with mild central canal stenosis.

L1-L2: Unremarkable.

L2-L3: Mild diffuse disc bulge. Mild facet arthropathy. No stenosis or
narrowing.

L3-L4: Mild-moderate diffuse disc bulge with bilateral foraminal endplate
ridging. Mild-moderate facet arthropathy. Mild left and minimal right neural
foraminal narrowing. Slight left lateral recess narrowing. No central canal
stenosis.

L4-L5: Diffuse disc bulge with superimposed small-moderate-sized focal
posterior central and left paracentral disc extrusion which extends slightly
inferior to the intervertebral disc space. Moderate bilateral facet
arthropathy. Left lateral recess stenosis and right lateral recess narrowing.
Mild left and minimal right neural foraminal narrowing. No significant central
canal stenosis.

L5-S1: Advanced degenerative disc disease with vacuum disc phenomenon. Diffuse
disc bulge. Small-moderate-sized focal left paracentral disc protrusion.
Advanced hypertrophic facet arthropathy. Bilateral lateral recess stenosis,
left worse than right. Mild central canal stenosis. Mild-moderate bilateral
neural foraminal narrowing...
IN A NUT SHELL...