Neck pain radiating to left trapezius/shoulder. Evaluate for cervical spinal stenosis versus neural foraminal stenosis. Craniovertebral junction appears within normal limits. There is straightening of the cervical spine with lordosis at the C2-C3 level which is likely related to patient position. There appears to be partial fusion involving the right C2-C3 facet joint. There is mild anterolisthesis of C3 on C4 and retrolisthesis of C4 on C5 and C5 on C6. The cervical spinal cord has normal signal characteristics.Degenerative changes are seen in the cervical spine with disc osteophyte complexes and significantly diminished disc space at the C3-C4, C4-C5, C5-C6, and C6-C7 levels, worst at the C3-C4 and C6-C7 levels. There is loss of height involving the C6 level. Vertebral body heights are otherwise grossly maintained. Individual levels as described below:C2-3: Small central disc protrusion and ligamentum flavum laxity without significant spinal canal or neural foraminal stenosis.C3-4: Small central disc protrusion and ligamentum flavum thickening with moderate spinal canal stenosis. There is up to moderate left and no significant right neural foraminal stenosis. There is prominent facet arthropathy on the left.C4-5: There is disc osteophyte complex and ligamentum flavum thickening with moderate spinal canal stenosis. There is mild to moderate left and mild right neural foraminal stenosis related to uncovertebral hypertrophy. C5-6: There is disc osteophyte complex with moderate spinal canal stenosis. There is mild bilateral neural foraminal stenosis related to uncovertebral hypertrophy.C6-7: Small disc osteophyte complex with minimal spinal canal stenosis. There is uncovertebral hypertrophy with mild bilateral 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.
Advanced multilevel degenerative changes in the cervical spine. There is moderate degree of spinal canal stenosis C3-C4, C4-C5, and C5-C6 levels. There is up to moderate left C3-C4 neural foraminal stenosis and milder degree at additional levels as above.