73-year-old female with right hip flexor weakness, foot drop. Suspect lumbar radiculopathy. Cord compression exam:On sagittal imaging, in the cervical spine, there are disc osteophyte complexes at multiple levels resulting in moderate to severe central canal stenosis, as detailed below in findings from dedicated imaging. There are mild degenerative disc findings in the thoracic spine, with moderate central canal stenosis at T10-11, also further discussed below. In the lumbar spine, there are bulging discs at multiple levels with moderate central canal stenosis at L4-5 and moderate bilateral foraminal narrowing at L5-S1. There is no evidence of epidural fluid collection or mass.Cervical spine:There is straightening of the normal cervical lordosis. The cervical vertebral bodies are appropriate in height. Mild degenerative endplate signal abnormality is seen at most levels.At C2-3 there is no significant compromise to spinal canal or neural foramina.At C3-4 there is disc bulge, posterior disc-osteophyte complex and uncovertebral arthropathy resulting in moderate central canal stenosis and mild mass effect on the ventral spinal cord with mild cord T2 hyperintensity. There is moderate right and moderate to severe left neuroforaminal stenosis. At C4-5 there is disc desiccation and loss of height, disc bulge, posterior disc-osteophyte complex with a prominent right paracentral component, and uncovertebral and facet arthropathy. These findings result in severe spinal canal stenosis with flattening of the ventral cord with cord T2 hyperintensity, as well as moderate to severe right and moderate left neuroforaminal stenosis.At C5-6 there is disc desiccation and loss of height, mild disc bulge, posterior disc-osteophyte complex, and uncovertebral arthropathy resulting in moderate central canal stenosis as well as mild right and mild to moderate left neuroforaminal stenosis.At C6-7 there is disc desiccation and loss of disc height, moderate central disc protrusion and uncovertebral arthropathy resulting in mild to moderate central canal stenosis, minimal deformation of the cord and minimal cord signal abnormality, as well as mild to moderate right and moderate to severe left neuroforaminal stenosis.At C7-T1 there is minimal disc bulge and facet hypertrophy, right greater than left, with no significant central canal stenosis and mild bilateral neuroforaminal stenosis.The vertebral artery flow voids appear to be intact.MRI thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is facet hypertrophy noted in the lower thoracic levels. At T10-11 there is additional moderate disc bulge with moderate central canal stenosis as well as moderate right and mild left neuroforaminal stenosis.
1.No evidence of acute cord compression.2.Multilevel chronic stenoses, severe at some levels in the cervical spine due to posterior disc-osteophyte complexes and posterior element hypertrophy. Patchy increased spinal cord signal in the cervical spine likely represents myelomalacia with or without mild superimposed edema. 3.Moderate central canal stenosis in the thoracic spine at T10-11.