53-year-old female with left hand weakness. The exam is degraded by patient motion artifact.There are small T2 hyperintensities in the pons, which are nonspecific but likely reflect age-indeterminate small vessel ischemic disease. The cranial-cervical junction is normal. There is reversal of the normal cervical lordosis. Mild loss of the C6 vertebral body height is again seen with associated endplate irregularities. The vertebral body heights are otherwise preserved. There is disc desiccation at all levels of the cervical spine and moderate loss of the intervertebral disc space at C5-6 and C6-7. There is stepwise degenerative retrolisthesis of C5 on C6 and C6 and C7. The bone marrow demonstrates a normal MR appearance other than mild endplate degenerative marrow changes at C5-C6 and C6-C7. The signal of the visualized cord is normal. The paraspinal soft tissues are unremarkable.There is no evidence of cord compression or mass. Degenerative changes are specified by the intervertebral level as follows: C2-C3: No neuroforaminal narrowing or spinal stenosis. C3-C4: Mild disc bulge but no neuroforaminal narrowing or spinal canal stenosis. C4-C5: There is left paracentral disc protrusion, which deforms the left ventral spinal cord and ventral left C5 nerve root. There is mild to moderate spinal canal stenosis and mild-to-moderate right neuroforaminal stenosis. Bilateral uncovertebral hypertrophy is also present.C5-C6: There is shallow central/left paracentral posterior disc osteophyte formation that results in mild spinal canal stenosis with slight flattening of the left ventral cord and moderate left neural foraminal narrowing. Left greater than right uncovertebral hypertrophy and right facet hypertrophy are also noted.C6-C7: There is mild posterior disc osteophyte formation with mild spinal canal stenosis, mild right neuroforaminal narrowing and mild to moderate left neuroforaminal narrowing. Bilateral uncovertebral hypertrophy is also noted.C7-T1: No neuroforaminal narrowing or spinal stenosis.
Multilevel cervical spine spondylosis, most pronounced C4-5 where there is impingement of the left ventral spinal cord and upon the ventral left C5 nerve root by a left paracentral disc protrusion. These findings do not appear significantly changed from the prior exam.