86-year-old female with weakness. This exam is extremely limited secondary to motion. There is reversal of cervical lordosis. Craniovertebral junction appears intact. Vertebral bodies are normal in height. There are numerous disc bulges evident, most significantly at C3-C4. There is significant spinal stenosis most notably at the C3-C4 and C4-C5 level. Alignment is maintained. Bone marrow signal is within normal limits. The cervical spinal cord is difficult to assess on this examination.Degenerative changes are seen in the cervical spine as described below:C2-3: There is a disc osteophyte complex and ligamentum flavum hypertrophy causing mild spinal stenosis without neural foraminal stenosis.C3-4: There is a broad disc osteophyte complex with substantial ligamentum flavum hypertrophy causing severe spinal stenosis with cord impingement and questionable left neural foraminal stenosis. The cord signal is difficult to ascertain due to artifact.C4-5: There is a disc osteophyte complex and ligamentum flavum hypertrophy causing mild-moderate spinal canal stenosis. There is mild right and moderate left neural foraminal stenosis.C5-6: There is a small disc osteophyte complex and right facet degeneration. There is anterior effacement of the thecal sac with moderate right and mild left neural foraminal stenoses.C6-7: There is a small disc osteophyte complex with a small amount of ligamentum flavum hypertrophy causing anterior effacement of the thecal sac. There is mild right neural foraminal stenosis.C7-T1: Mild disc osteophyte complex.The upper thoracic spine demonstrates multiple disc bulges.
Multilevel degenerative changes including disc bulges, ligamentum flavum hypertrophy, and neural foraminal stenoses. These are most apparent at C3-C4 and C4-C5 where there is spinal stenosis and cord impingement.