Clinical question:Rule out cord compression. Signs and symptoms: Bilateral lower extremity weakness, urinary/stool incontinence, paresthesias of large toes. Non-enhanced total spine MRI:Examination is performed utilizing cord compression protocol and without axial images.Examination of thoracic and lumbar spine demonstrate normal anatomic alignment the vertebral column. No evidence of spinal canal compromise or stenosis at any level. No detectable mass effect on the cord or thecal sac at any level. There is normal signal intensity and caliber of cord. There is no detectable perispinal soft tissue abnormalities.Nonenhanced cervical MRI:Examination demonstrate normal anatomical alignment the vertebral column.Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 is unremarkable.C4 -- C5 demonstrate mild degenerative changes and unremarkable otherwise.C5 -- C6 demonstrate moderate disk disease, loss of disk height and mild facet and ligamentum flavum degenerative changes. There is resultant significant bilateral neural foraminal compromise and moderate central spinal stenosis. Mild flattening and posterior displacement of the cord secondary to degenerative changes is noted.C6 -- C7 demonstrate moderate disk disease and loss of disk height and mild bilateral facet and ligamentum flavum degenerative changes. There is no spinal stenosis however moderate right and mild to moderate the left neural foraminal compromise is noted.C7 -- T1 demonstrate mild right neural foraminal compromise and unremarkable otherwise.
1.Nonenhanced MRI of cervical spine demonstrates degenerative changes at C5 -- C6 with resultant significant neural foraminal compromise and moderate central spinal stenosis. At C6 -- C7 moderate right and mild to moderate left neural foraminal compromise is noted. Unremarkable exam otherwise.2.Nonenhanced total spine MRI demonstrate no evidence of cord compression. Unremarkable sagittal only images of thoracic and lumbosacral spine.