Clinical question: Evaluate cervical abnormality/stenosis. Signs and symptoms: Clumsy hands, weakness. Nonenhanced cervical MRI:The signal intensity of the vertebral column demonstrate changes related to degenerative disease and unremarkable otherwise.The alignment of vertebral column is anatomical.There is generalized uniform narrowing of the spinal canal on sagittal images. The finding although partially secondary to uniform posterior longitudinal hypertrophy possibility of underlying congenital anatomical variation should also be considered.Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes with resultant mild right neural foraminal compromise and unremarkable otherwise.C3-C4 demonstrate moderate disc disease and loss of disc height, asymmetric (R>L) uncovertebral hypertrophy with resultant significant right and moderate to significant left neural foraminal compromise. There is a ventral hypertrophic spur which results in slight flattening and posterior displacement of the cord and moderate central spinal stenosis. There is no detectable cord signal abnormality.C4-C5 demonstrate moderate disc disease and loss of disc height, mild bilateral ligamentum flavum hypertrophy and mild facet disease. Constellation of changes results in significant left and moderate right neural foraminal compromise and mild central spinal stenosis.C5-C6 demonstrate moderate disc disease and loss of disc height, mild bilateral facet and ligamentum flavum hypertrophy and asymmetric (L>R) uncovertebral hypertrophic changes. Constellation of changes results in significant right and moderate to significant left neural foraminal compromise and moderate central spinal stenosis.C6-C7 demonstrate moderate disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease. There is asymmetric uncovertebral hypertrophic changes (L>R) present. Constellation of changes results in complete effacement of subarachnoid space, flattening and posterior displacement of the cord, moderate central spinal stenosis and significant bilateral neural foraminal compromise.C7-T1 demonstrate moderate disc degeneration and loss of disc height, moderate bilateral ligamentum flavum and mild bilateral facet hypertrophic changes. Constellation of changes could results in mild central spinal stenosis and significant left neural foraminal compromise.There is no detectable signal abnormality of the cord.There is no detectable. Spinal soft tissue abnormalities. Partially visualized T2-T3 disc level demonstrates a prominent midline ventral epidural defect with suggestion of subtle mass effect on the ventral aspect of the cord. Finding likely representing degenerative changes. Correlate with neurological exam and consider follow-up with thoracic MRI if clinically warranted.
1.Extensive degenerative changes of cervical spine primarily of disc disease as well as uniform hypertrophy of posterior longitudinal ligament. Findings resulting in multilevel central spinal stenosis at C3-C4 through C7-T1 levels. Worse stenosis appears to be at C5-C6 and C3-C4 levels as detailed.2.Degenerative changes also results in multilevel bilateral neural foraminal compromise (several significantly) as detailed per level above.3.There is normal signal intesity of the cervical cord.4.Degenerative disease of partially visualized T2-T3 level as detailed above. Correlate with neurological exam and consider follow-up with dedicated imaging.