70-year-old male with neck pain and numbness in left arm Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is loss of normal cervical lordosis with minimal retrolisthesis of C4 and C5 and minimal anterolisthesis of C5 on C6. There is also mild anterolisthesis of C7 on T1. Alignment is maintained. Multilevel vertebral body endplate degenerative changes are noted.Focal signal abnormality within the spinal cord at C4/5 with volume loss.Degenerative changes are seen in the cervical spine as described below:C2-3: Small disk bulge without significant compromise to the spinal canal or neural foramina.C3-4: Disk osteophytes complex, bilateral uncovertebral hypertrophy and facet hypertrophy, resulting in mild spinal canal narrowing and severe bilateral neuroforaminal narrowing. C4-5: Disk osteophytes complex, bilateral uncovertebral hypertrophy and facet hypertrophy, resulting in severe left and moderate to severe right neuroforaminal narrowing. Moderate ligamentum flavum hypertrophy. There is moderate to severe spinal canal stenosis.C5-6: Disk osteophytes complex, bilateral uncovertebral hypertrophy, facet hypertrophy, and ligamentum flavum hypertrophy. Moderate to severe right and severe left neuroforaminal narrowing. Severe spinal canal stenosis.C6-7: Uncovertebral joint hypertrophy with moderate to severe right and moderate left neuroforaminal narrowing. No significant spinal canal stenosis.C7-T1: Uncovertebral hypertrophy and facet arthropathy, with moderate left and mild right neuroforaminal narrowing. No significant spinal canal narrowing. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Advanced degenerative changes with moderate to severe multilevel neuroforaminal narrowing and moderate to severe spinal canal stenosis as detailed above. At C4/5 there is focal cord signal abnormality consistent with myelomalacia.