56M with h/o cervical arthritis, x-ray with degenerative changes, patient has decreased ROM and radicular pain (R > L arm) described as shooting, ?lesion amenable to surgery for pain relief? Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from loss of cervical lordosis. Bone marrow signal is benignThe cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine with multilevel disc desiccation and disc height loss which is worst at the C4-C5 level. Individual levels as below: C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Partial effacement of the ventral thecal sac without significant spinal canal stenosis overall. No significant neural foraminal stenosis.C4-5: Small disc osteophyte complex and uncovertebral hypertrophy on the right resulting in mild to moderate right-sided neural foraminal stenosis. No significant spinal canal compromise or left neural foraminal narrowing.C5-6: No significant compromise to the spinal canal or neural foramina.C6-7: Small disc osteophyte complex and uncovertebral hypertrophy on the left. There is no significant spinal canal stenosis. There is mild to moderate left neural foraminal narrowing. No significant right neural foraminal narrowing.C7-T1: No significant compromise to the spinal canal or neural foramina.Right vertebral artery is diminutive which may be related high-grade stenosis. Paraspinous soft tissue structures appear within normal limits.
1. Multilevel degenerative changes in the cervical spine. There is mild to moderate right C4-C5 and left C6-C7 neural foraminal stenoses. There is no significant spinal canal stenosis at any level.2. Right vertebral artery flow-void is diminutive which may be related to high-grade stenosis. Dedicated CTA or MRA neck may be considered for better assessment.