Clinical question: Evaluate for spinal stenosis. Signs and symptoms:Poor balance, history of cervical spine surgery. Nonenhanced cervical MRI:Examination demonstrates extensive degenerative disk disease at C4 -- C5 through C7 -- T1 levels and to a lesser degree at other levels. There is resultant mild S-shaped deformity of the cervical spinal.Foramen magnum is unremarkable.C2 -- C3 demonstrate asymmetric hypertrophic changes on the right with right facet hypertrophy changes resultant severe right neural foraminal compromise and unremarkable otherwise.C3 -- C4 demonstrate asymmetric significant right facet hypertrophic changes and asymmetric right-sided uncovertebral hypertrophy resulting in significant right neural foraminal compromise and unremarkable otherwise.C4 -- C5 demonstrate significant disk disease and loss of disk height, significant asymmetric right-sided uncovertebral osteophyte formation and mild asymmetric right facet complex hypertrophy. Constellation of changes at this level results in significant bilateral neural foraminal compromise and moderate central spinal stenosis. There is mass effect and flattening deformity of the ventral aspect of the cord on the right secondary to asymmetric right uncovertebral osteophyte formation. The signal intensity of the cord remains normal.C5 -- C6 demonstrate asymmetric (right greater than left) degenerative changes. Large right-sided uncovertebral osteophyte and to a lesser degree on the left results in mass effect and flattening deformity of the cord and and moderate central spinal stenosis. Significant right and moderate to significant left neural foraminal compromise at this level is also noted.C6 -- C7 demonstrate advanced disk disease with loss of disk height, mildly asymmetric (left greater than right) hypertrophic changes of facet is noted. There is mild central spinal stenosis and significant (left greater than right) neural foraminal compromise at this level.C7 -- T1 demonstrate advanced disk disease with near complete loss of disk height, mild hypertrophic changes of posterior elements, mild grade 1 anterolisthesis. Constellation of changes results in mild central spinal stenosis and moderate bilateral neural foraminal compromise.The signal intensity of the cervical and the upper most visualized thoracic cord to T3 level is within normal.
1.Nonenhanced MRI of cervical spine demonstrate advanced degenerative changes of disks and the posterior elements and asymmetric (right greater than left) fashion likely secondary to scoliosis as detailed.2.Changes results in central spinal stenosis of varying degree at C4 -- C5, C5 -- C6, C6 -- C7 and C7 -- T1 levels.3.There are also multi-level significant neural foraminal compromise as detailed per level above.4.Although there is flattening deformity of the cord at the levels of spinal stenosis, the signal intensity of the cord however remains within normal.