Fall. History of stroke. The study is limited by patient motion.Cervical spinal alignment is notable for partial straightening which may relate to patient positioning. The vertebral bodies are preserved in height. There is mild multilevel degenerative marrow signal abnormality subjacent to the endplates, most pronounced at C3-C4, but no suspicious marrow abnormality. This is associated with multilevel loss of disc height and T2 signal, most pronounced at C5-C6 and C7-T1, where it is moderate. Multilevel shallow ventral indentations of the thecal sac are also present as described below, but there is no significant spinal canal stenosis. The cervical spinal cord shows normal morphology and signal, accounting for motion. There are secretions along the posterior nasopharyngeal/oropharyngeal wall but no abnormal soft tissue signal in the prevertebral soft tissues. There is also a small catheter extending from the esophagus below reaching superiorly to the lower most nasopharynx along posterior pharyngeal wall to the right of midline. It is not visible above this level but this may relate to the lack of fluid within the catheter lumen.C2-C3: No significant degenerative disc disease or spinal canal stenosis. Minimal left neural foraminal stenosis by uncovertebral arthropathy.C3-C4, C4-C5, C5-C6: Flattening of the anterior thecal sac by disc-osteophyte complex but no significant spinal canal stenosis. Mild bilateral neural foraminal stenosis by uncovertebral and facet arthropathy.C6-C7: No significant additional disc disease or spinal canal stenosis. No significant neural foraminal stenosis.C7-T1: Flattening of the anterior thecal sac by disc-osteophyte complex. Left more than right uncovertebral and facet arthropathy and moderate left neural foraminal stenosis.
1.Multilevel degenerative cervical spondylosis is relatively mild and results in no significant spinal canal stenosis. 2.There is moderate left C7-T1 foraminal stenosis. There is no or mild foraminal stenosis at the other levels as described above.3.The catheter in the esophagus is not visible by MRI above the soft palate which may be related to the lack of fluid within the catheter lumen. The possibility of malposition or retained tube across the oropharynx to upper esophagus would be better assessed clinically. Dr. Monther Qandeel discussed the above findings and recommendations with the NeuroICU residents (including Dr. Robin A Buerki) over the phone on 1/7/2016 at 1400 hours.