Clinical question: Critical cervical stenosis requiring surgery. Signs and symptoms: Weak grip. Nonenhanced cervical MRI:There is normal anatomical alignment of vertebral column.Unremarkable signal intensity of the vertebral column other than changes related to degenerative disease.Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative degenerative disease and unremarkable otherwise.C3-C4 demonstrate moderate disc disease and loss of disc height, mild bulging disc and mild ligamentum flavum hypertrophy. Constellation of changes results in moderate central spinal stenosis, severe right and moderate left neural foraminal compromise.C4-C5 demonstrate mild disc disease and loss of disc height, shallow bulge of disc and moderate ligamentum flavum hypertrophy. Constellation of changes results in flattening and posterior displacement of the cord and severe central spinal stenosis with moderate right neural foraminal compromise.C5-C6 demonstrate mild degenerative disc and hypertrophic changes of posterior elements without spinal stenosis and mild right neural foraminal compromise.C6/C7 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.C7-T1 demonstrate mild disc disease and mild bilateral facet and ligamentum flavum hypertrophy. There is no spinal stenosis however moderate right and mild-to-moderate left neural foraminal compromise is present.There is no evidence of signal abnormality of cervical or upper most visualized thoracic cord.
1.Degenerative changes at C3-C4 results in moderate central spinal stenosis and with severe right and moderate left neural foraminal compromise.2.Degenerative changes at C4-C5 resulting in severe central spinal stenosis an moderate right neural foraminal compromise.3.Normal signal intensity of the cervical and upper most visualized thoracic cord.4.Mild degenerative changes at other levels however without central spinal stenosis as detailed per level above.