Clinical question: Further evaluation for disc herniation. Signs and symptoms: Myelopathy, preop planning. Nonenhanced cervical MRI:Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes and unremarkable otherwise.C3-C4 demonstrate mild degenerative disc disease with resultant moderate left and mild right neural foraminal compromise and no central spinal stenosis.C4-C5 demonstrate moderate disc disease and loss of disc height and mild bilateral facet and ligamentum flavum hypertrophic changes. Shallow mental hypertrophic spur on the left results in slight flattening and posterior displacement of the cord and moderate central spinal stenosis. Moderate bilateral neural foraminal compromise is also present.C5-C6 demonstrate a large disc extrusion extending superiorly to mid C5 level and inferiorly to mid C6. Although the prior exam was incomplete there is no significant change of this finding which results in significant central spinal stenosis. The extruded disc is more prominent to the left of midline. Significant bilateral neural foraminal compromise is also present. On sagittal T2 STIR there is evidence of increased T2/T2 STIR signal intensity of the cord at this level suggestive of myelitis.C6-C7 demonstrate moderate disc disease, loss of disc height, mild hypertrophic changes of facet and ligamentum flavum. There is a shallow bulging disc with resultant subtle flattening the ventral aspect of the cord and mild central spinal stenosis.C7-T1 is unremarkable.Upper most visualized thoracic spine and thoracic cord to T3 level is unremarkable.
1.C5-C6 demonstrate a large disc extrusion with resultant significant central spinal stenosis and increased T2 signal intensity of the cord/myelitis.2.C4-C5 demonstrate degenerative changes with resultant moderate central spinal stenosis and neural foraminal compromise as detailed.3.C6-C7 demonstrate degenerative changes with resultant mild central spinal stenosis and neural foraminal compromise.4.See detailed report per level above.