Left-sided neck pain with radicular symptoms to all 5 fingers, status post radiation for head and neck cancer. Evaluate for stenosis. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained aside from minimal retrolisthesis of C4 on C5 and C5 on C6. Bone marrow signal is benign with diffuse T1 shortening related to prior radiation.The cervical spinal cord has normal signal characteristics and overall morphology.There is developmental narrowing of the cervical spinal canal with superimposed degenerative changes as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Disc osteophyte complex eccentric to the right with prominent right-sided uncovertebral hypertrophy. There is also a small right central disc protrusion and ligamentum flavum thickening. Mild spinal canal stenosis. There is mild to moderate right-sided neural foraminal stenosis. Left neural foramen is patent.C4-5: Disc osteophyte complex eccentric to the right with right-sided uncovertebral hypertrophy. There is also mild ligamentum flavum thickening. There is mild to moderate spinal canal stenosis, relatively greater involving the right aspect of the spinal canal. There is mild to moderate right-sided neural foraminal stenosis. Left neural foramen is patent.C5-6: Disc osteophyte complex and bilateral uncovertebral hypertrophy. There is also mild ligamentum flavum thickening. There is moderate degree of spinal canal stenosis. There is moderate to severe left and, to a slightly lesser degree, right neural foraminal stenosis. C6-7: Mild disc bulge eccentric to the right and mild bilateral uncovertebral hypertrophy. There is also mild ligamentum flavum thickening. There is moderate right and mild left neural foraminal stenosis. Mild spinal canal narrowing.C7-T1: Minimal disc bulge eccentric to the right without significant compromise to the spinal canal or left neural foramen. Minimal right neural foraminal narrowingThe vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Multilevel degenerative changes in the cervical spine, worst at the C5-C6 level where there is moderate degree of spinal canal stenosis and moderate to severe left neural foraminal stenosis. The left-sided neural foramina are grossly patent at the other levels. Additional details as above.2. No cord signal abnormality. No suspicious osseous lesions.