Right lower extremity hyperreflexia and acute weakness. Evaluate for stenosis (cord or nerve impingement). Alignment of the cervical spine is anatomic. Bone marrow signal is benign with T1 hyperintense foci such as at the T2 vertebral body compatible with hemangioma or focal fat. No suspicious osseous lesions are seen.The spinal canal shows mild to moderate narrowing at the C3-C4 and C5-C6 levels as described below. Examination is motion degraded however no definite cord signal abnormality is appreciated.Multilevel degenerative changes, as described below:C2-C3: Small central/right paracentral disc-osteophyte complex indents the anterior aspect of the thecal sac and touches the spinal cord. The neural foramina are open.C3-C4: Left more than right facet and uncovertebral proliferative change results in mild bilateral foraminal narrowing. There is also ligamenta flava thickening contributing to mild to moderate spinal canal narrowing. Prominent left-sided facet arthropathy.C4-C5: Disc-osteophyte complex and uncovertebral hypertrophy causes mild canal narrowing and mild to moderate left foraminal stenosis. Left-sided facet arthropathy is evident.C5-C6: There is a disc extrusion that mild to moderately narrows the spinal canal. There is left more than right uncovertebral proliferative change which contribute to narrowing of the left neural foramen.C6-C7 and C7-T1: There is no significant spinal canal or foraminal narrowing.
Multilevel cervical spondylosis associated with mild to moderate spinal canal stenosis at C3-C4 and C5-C6. Examination is motion degraded however demonstrates no convincing cord signal abnormality. Foraminal narrowing is also suboptimally evaluated due to motion but is evident at multiple levels as detailed above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.