Cervicalgia, paresthesias. Chronic low back pain, leg weakness, history of trauma. Cervical spine: The cervical vertebral bodies are appropriate in height. There is loss of cervical lordosis with minimal retrolisthesis of C4 on C5 and C5 on C6. Alignment is otherwise maintained. There is irregularity involving the left lateral mass of C1 with suggestion of loss of height on the left and may be on a degenerative basis; CT can better assess this finding if clinically warranted although there is no significant edema in this region to suggest acute inflammation in this region. There is moderate degree of bone marrow edema associated with facet arthropathy at the left C2-C3 facet joint. Bone marrow signal is benign.The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal. There is moderate left and mild right neural foraminal stenosis with prominent facet arthropathy on the left as above.C3-4: There is no spinal canal stenosis. There is moderate to severe right neural foraminal stenosis related to severe right-sided facet arthropathy. There is mild facet arthropathy on the left and mild to moderate left neural foraminal stenosisC4-5: No significant compromise to the spinal canal. Bilateral uncovertebral hypertrophy and bilateral facet arthropathy, which is worse on the left. There is associated moderate to severe left and moderate right neural foraminal stenosis.C5-6: Severe loss of disc height with mild associated edema in the adjacent vertebral bodies. There is a disc osteophyte complex, bilateral uncovertebral hypertrophy, and bilateral facet arthropathy with moderate spinal canal stenosis. There is severe bilateral neural foraminal stenosis.C6-7: Small disc defect complex and bilateral uncovertebral hypertrophy. Mild spinal canal narrowing and moderate to severe bilateral neural foraminal stenosis. C7-T1: No significant compromise to the spinal canal. There is mild to moderate left and mild right neural foraminal stenosis. There is bilateral facet arthropathy with mild distention of the facet joint on the left.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Lumbar spine: Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. Alignment is within normal limits aside from straightening of the normal lordotic curvature. There is severe loss of disc height at the L5-S1 level with suggestion of vacuum phenomena. There is also disc desiccation at L4-L5 with minimal overall height loss. There is suggestion of a pars defect or cleft involving the left L5 posterior neural arch (not well evaluated with MRI) but without associated edema.Bone marrow signal is benign. The conus medullaris is normal in position.Multilevel degenerative changes are seen, as described below:L1-L2: No significant disc disease. No spinal canal or neural foraminal stenosis.L2-L3: No significant disc disease. No spinal canal or neural foraminal stenosis.L3-L4: No significant disc disease. No spinal canal or neural foraminal stenosis. Mild facet arthropathy.L4-L5: Mild disc bulge with dorsal annular fissure and moderate facet arthropathy, worse on the left. There is no significant spinal canal stenosis. There is mild left and minimal right neural foraminal narrowing.L5-S1: There is a disc bulge without significant spinal canal stenosis. There is moderate right neural foraminal stenosis and mild left neural foraminal stenosis. Paraspinous soft tissues are within normal limits.
1. Degenerative changes throughout the cervical spine, worst at the C5-C6 level where there is moderate spinal canal stenosis and severe bilateral neural foraminal stenosis. There is also multilevel cervical facet arthropathy including edema associated with the left C2-C3 facet arthropathy. Additional levels in the cervical spine as detailed above. 2. Degenerative changes in the lumbar spine, particularly at the L5-S1 level. There is no significant spinal canal stenosis at any level in the lumbar spine. There is moderate right and mild left L5-S1 neural foraminal stenosis. There is also facet arthropathy in the lumbar spine, worst at the left L4-L5 level.