Neck pain radiating to right shoulder. Evaluate for stenosis, disc herniation or other abnormality Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is loss of cervical lordosis. Alignment is otherwise maintained. Bone marrow signal is benign. There is mild apparent thickening along the posterior longitudinal ligament from C4 to C6; possible calcifications can be better appreciated with CT. There is small linear focus of T2 hyperintensity involving the right lateral aspect of the cervical cord at the C5-C6 level likely representing myomalacia. Remainder of the cervical cord is normal in signal.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: There is a right paracentral disc protrusion which effaces the right lateral aspect of the ventral thecal sac. Spinal canal and neural foramina are otherwise patent.C4-5: There is a central disc protrusion which partially flattens the ventral cervical cord. There is overall moderate to severe spinal canal stenosis at this level. Neural foramina are patent. C5-6: There is a disc osteophyte complex including bilateral uncovertebral hypertrophy. There is partial flattening of the cervical cord and moderate to severe spinal canal stenosis. There is abnormal T2 hyperintensity involving the lateral aspect of the cervical cord on the right. There is also moderate left and mild to moderate right neural foraminal stenosis.C6-7: There is a disc osteophyte complex including uncovertebral hypertrophy. There is partial flattening of the cervical cord with moderate to severe spinal canal stenosis. There is mild right and minimal left neural foraminal stenosis. C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Moderate to severe spinal canal stenosis at the C4-C5, C5-C6, and C6-C7 levels. There is abnormal T2 hyperintensity involving the lateral aspect of the cervical cord on the right at the C5-C6 level likely representing myelomalacia.2. Neural foraminal stenoses are relatively worse at the left C5-C6 and right C6-C7 levels. There is also a right paracentral disc protrusion at C3-C4 which appears to contact the right-sided C4 nerve rootlets proximal to the neural foramen.