58-year-old female with left arm numbness and lower back pain. Cervical Spine:Craniovertebral junction appears within normal limits. There is mild retrolisthesis at C5-6 and reversal of the cervical lordosis. The cervical vertebral bodies are appropriate in height. Bone marrow signal is within normal limits without focal lesions identified. Ventral effacement of the thecal sac is noted between C5 and C7 but the dorsal thecal sac is patent at all levels. Normal cord caliber without concerning areas of signal abnormality. No paraspinal soft tissue mass.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: No significant compromise to the spinal canal or neural foramina.C4-5: No significant compromise to the spinal canal or neural foramina.C5-6: Moderate loss of disc space height and posterior disc osteophyte complex. Mild central canal narrowing. Uncovertebral joint hypertrophy causes moderate left and mild right neuroforaminal narrowing.C6-7: Posterior disc osteophyte complex and superimposed central disc extrusion causes mild central canal narrowing with minimal indentation of the spinal cord. Minimal left foraminal narrowing due to uncovertebral joint osteophytes. No right foraminal narrowing.C7-T1: Minimal left foraminal narrowing due to uncovertebral joint osteophytes. No central or right foraminal narrowing.T1-2: No significant compromise to the spinal canal or neural foramina.Mild posterior disc bulge at T2-3 seen on sagittal images only. Lumbar Spine: Five lumbar type vertebral bodies are presumed to be present. Alignment and vertebral body heights are preserved. High T2 signal within the anterior L5 vertebral body likely represents focal fat or an intraosseous hemangioma; the bone marrow signal is otherwise within normal limits. The conus medullaris is normal in position at the level of L1. The visualized thoracic cord is normal in caliber and signal. Paraspinous soft tissues are within normal limits.Mild facet arthropathy and disc bulges are seen at all levels, but there is no high grade spinal or neuroforaminal narrowing. There is minimal right foraminal narrowing at L2-3 and minimal left foraminal narrowing at L3-4.Just above the right L4 nerve root in the neural foramen, there is a linear structure with identical signal that may represent a vessel or conjoined nerve root. Contrast may be used to differentiate but finding is of doubtful clinical significance.Small right foraminal disc protrusion causes mild neuroforaminal narrowing at L5-S1, best appreciated on axial images.
1.Multilevel degenerative changes in the cervical spine, most pronounced at C5-6 and C6-7 as described above. Most notably, there is moderate stenosis of the left neural foramen at C5-6 which may be impinging on the left C6 nerve root.2.Mild scattered degenerative changes in the lumbar spine, as detailed above, without high grade spinal or neuroforaminal stenosis.