62 year old female with a history of multi-level cervical stenosis. There is loss of the normal cervical lordosis which is likely a combination of positioning and degenerative change. There is also degenerative grade 1 anterolisthesis of C4 upon C5 and grade 1 retrolisthesis of C5 upon C6. No acute malalignment is present. There is preservation of the vertebral body heights with no evidence of acute fracture. However, degenerative endplate changes are present at C3 through C7 resulting in some sclerosis and, at the inferior endplates of C3 and C4, Schmorl's nodes. Anterior osteophytes are noted at several cervical spine levels, most conspicuous at C5/C6 and C6/C7 with associated elevation of the prevertebral muscles. Multilevel degenerative disk disease is present. By level:C2/C3: Right paracentral disk protrusion with associated partial thecal sac effacement. There is mild right and moderate left sided facet arthropathy but no neural foraminal narrowing.C3/C4: There is moderate loss of intervertebral disk height. Note is made of a Schmorl's node indenting the inferior endplate of C3. There is a posterior disk osteophyte complex and mild ligamentum flavum hypertrophy associated with effacement of the dorsal and ventral thecal sac. Additionally, there is moderate bilateral facet arthropathy, moderate uncovertebral hypertrophy, and mild bilateral neuroforaminal stenosis. C4/C5: Grade 1 anterolisthesis of C4 on C5. There is mild loss of the intervertebral disc height with an associated vacuum disk. Note is made of a moderate posterior disk osteophyte complex and ligamentum flavum hypertrophy with resulting dorsal and ventral thecal sac effacement. On subsequent MRI, there was found to be mild cord flattening and cord signal increase at this level. There is also severe right-sided and moderate left-sided facet arthropathy, mild uncovertebral hypertrophy, and mild right-sided neuroforaminal stenosis. C5/C6: There is severe loss of the intervertebral disk height in the context of grade I retrolisthesis and vacuum disk. There is a posterior disc osteophyte complex associated with dorsal and ventral thecal sac effacement. On subsequent MRI, there was found to be mild cord flattening at this level. There is minimal uncovertebral hypertrophy and mild bilateral facet arthropathy. There is no evidence of neuroforaminal stenosis. C6/C7: There is moderate loss of the intervertebral disc height with associated vacuum phenomenon. There is a posterior disc osteophyte complex with associated partial effacement of the dorsal and ventral thecal sac. There is mild uncovertebral hypertrophy and minimal bilateral neuroforaminal stenosis. C7/T1: Minimal bilateral facet arthropathy. No evidence of uncovertebral hypertrophy or disc herniation.There is no exophytic aerodigestive tract mass, but there is noted to be asymmetric fullness of the right lingual tonsil--this region is found to have signal characteristics indistinguishable from lymphoid tissue on the subsequently performed MRI. There is mild mucosal thickening of the sphenoid sinuses. Paraspinal soft tissues unremarkable. There is no enlargement of the cervical lymph nodes by CT criteria. Moderate left greater than right carotid bifurcation calcification.The visualized intracranial contents are unremarkable apart from vascular calcifications of the left cavernous carotid artery are noted. The apices of the lungs are clear bilaterally.
Severe multilevel degenerative changes of the cervical spine most prominent at the levels of C3/C4, C4/C5, C5/C6, and C6/C7. Subsequent MRI identifies thecal sac effacement at these levels with mild cord flattening at C4/C5 and C5/C6 and cord signal increase at C4/C5.Fullness of right lingual tonsil, at MRI found to have signal characteristics similar to surrounding lymphoid tissue. Suggest clinical correlation.