Left arm weakness, brisk reflexes, 30 pack-year history of smoking. Rule out cervical disc herniation or tumor compression. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from mild reversal of cervical lordosis and minimal anterolisthesis of C3 on C4. Bone marrow signal is benign. No suspicious lesions to suggest neoplasm. The cervical spinal cord has normal signal characteristics.Degenerative changes are seen in the cervical spine with multilevel disc desiccation and moderate disc height loss at the C6-C7 level. Additional details as described below: C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: No significant compromise to the spinal canal or neural foramina.C4-5: There is disc bulge and mild bilateral uncovertebral hypertrophy. There is mild spinal canal stenosis. There is moderate right and mild left neural foraminal stenosis.C5-6: There is a left paracentral disc protrusion which indents the ventral left aspect of the cord with moderate stenosis primarily involving the left aspect of the spinal canal. There may be impingement of the left C6 nerve rootlets proximal to the neural foramen. There is minimal left and no significant right neural foraminal narrowing.C6-7: Small disc osteophyte complex with uncovertebral hypertrophy and ligamentum flavum thickening. There is mild spinal canal stenosis. There is mild to moderate bilateral neural foraminal stenosis. C7-T1: Minimal disc bulge with minimal narrowing of the neural foramina, relatively greater on the left. Spinal canal is patent. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.Partially imaged brain demonstrates T2 hyperintensity involving the pons, better seen on prior brain MRI and may relate to chronic small vessel ischemic disease.
1. Multilevel degenerative changes in the cervical spine, worst at the C5-C6 level where there is a prominent left paracentral disc protrusion which indents the left lateral aspect of the spinal cord and may also be affecting the left-sided nerve rootlets proximal to the neural foramen. There is moderate stenosis involving the left aspect of the spinal canal at this level. No cord signal abnormality.2. There is also mild spinal canal stenosis at the C4-C5 and C6-C7 levels. There is also multilevel neural foraminal stenoses as detailed above, worst at the right C4-C5 level where there is moderate stenosis.3. No suspicious lesions to suggest neoplasm.