Clinical question: History of cervical discectomy complains of neck pain. Findings and symptoms: Snoring snoring, neck pain, history of discectomy. Nonenhanced cervical MRI:Examination demonstrates expected chronic post operative changes of anterior approach spinal fusion at C5, C6 and C7 levels. There is an anterior metallic plate at these levels and with placement of fixating screws into the vertebral bodies of C5, C6 and C7. There is suggestion of fusion of the disc spaces at these levels and repeat maintained anatomical alignment similar to prior exam.The signal intensity of vertebral column is unremarkable other than findings related to prior surgery and degenerative changes.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild degenerative disc disease and small bilateral (L>R) uncovertebral hypertrophic spurs. No spinal stenosis however mild to moderate (R>L) bilateral neural foraminal compromise are detected. Degenerative changes at this level demonstrate no significant change since prior exam.C4-C5 demonstrates moderate disc disease and loss of disc height and mild facet hypertrophic changes with resultant moderate left neural foraminal compromise and unremarkable otherwise. Findings at this level remain fairly similar to prior study from February 2015.C5-C6 demonstrate postoperative changes, shallow right paramedian hypertrophic spur however without central spinal stenosis. Significant right and moderate left neural foraminal compromise similar to prior exam.C6-C7 demonstrate postoperative changes of prior fusion without spinal stenosis. There is redemonstration of bilateral uncovertebral hypertrophic changes with resultant moderate to severe bilateral neural foraminal compromise. Findings remain grossly similar to prior exam.C7-T1 demonstrate postop changes without central spinal stenosis. Trace anterolisthesis similar to prior exam. Severe left (sagittal T2 series 3 image 16 and 17) and mild to right neural foraminal compromise (sagittal T2 series 3 images and 7).The signal intensity and morphology of the cervical and upper most visualized thoracic cord remains feeding normal.On sagittal T2-weighted images there is suggestion of a small central disc protrusion at T2-T3 level with resultant effacement of subarachnoid space and contact with the cord. No axial images were acquired. There is no spinal stenosis or neural foraminal compromise at this level.
1.No evidence of an acute or convincing evidence of a new finding since prior MRI exam from February 2015.2.Stable postoperative changes of an anterior spinal fusion at C5-C7 as detailed.3.No evidence of central spinal stenosis at any level.4.Multiple levels of neural foraminal compromise of varying degree secondary to degenerative disease as detailed per level above.