Male, 16 years old, with history of ligamentous injury to the neck in 2008, status post halo fixation and fusion from the axis to C3, now presenting with new neck pain. Cervical spine:Posterior fusion instruments are evident from the occiput to the C3 level. Osseous fusion of the craniocervical junction is demonstrated with incorporation of the basiocciput, odontoid process, lateral masses of C1 and C2 and the anterior C1 arch, as well as the posterior occiput and the posterior elements of C1-C3.Apart from the fusion-induced straightening of the cervical lordosis, sagittal alignment is otherwise unremarkable. Vertebral body heights are preserved. No evidence of marrow edema or marrow replacement is seen.The visualized spinal cord shows normal signal intensity and morphology throughout. No epidural abnormalities are suspected. The paraspinal and ligamentous soft tissues are unremarkable.At C7-T1, loss of disc T2 signal is demonstrated as well as a small left foraminal protrusion. The spinal canal is not significantly compromised. However, there is moderate left and mild right foraminal narrowing. The remaining levels are free of significant stenosis.Brain:Brain parenchymal morphology and signal characteristics are within normal limits. No focal lesion, edema or mass effect is detected. No evidence of acute intracranial hemorrhage or any abnormal extra-axial fluid is seen. The ventricles are normal in size and morphology.
1.Findings compatible with successful osseous fusion of the craniocervical junction.2.No evidence of any acute cervical spine injury. Disc degeneration at C7-T1 results in moderate left and mild right foraminal narrowing.3.Unremarkable evaluation of the brain.