Clinical question: Rule out stenosis. Signs and symptoms: Neck pain. Nonenhanced cervical MRI:Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate mild left uncovertebral hypertrophy with resultant mild left neural foraminal compromise.C4 -- C5 demonstrate moderate disk disease, loss of disk height and minimal hypertrophy changes of posterior elements. No spinal stenosis. Mild bilateral neural foraminal compromise however is present.C5 -- C6 demonstrate moderate disk disease and loss of disk height, mild bilateral ligamentum flavum hypertrophy and mild facet disease (right greater than left). No spinal stenosis however moderate right neural foraminal compromise is detected.C6 -- C7 demonstrate moderate disk disease and loss of disk height, mild to moderate bilateral ligamentum flavum hypertrophy and mild degenerative facet disease. There is a ventral hypertrophic spur with resultant partial effacement of ventral subarachnoid space which in combination with hypertrophic changes of ligamentum flavum results in mild central spinal stenosis. Moderate bilateral neural foraminal compromise is also detected. There is a well demarcated CSF signal intensity within the right neural foraminal laterally likely representing a prominent nerve sheet/Tarlov cyst.C7 -- T1 demonstrate minimal degenerative disk disease and mild bilateral ligamentum flavum and facet (left greater than right) hypertrophic changes. No spinal stenosis or convincing there is some neural foraminal compromise. A well-demarcated small focus of marrow signal change in the dorsal aspect of body of C7 is consistent with a skeletal capillary hemangioma.Degenerative changes all cervical spine at C4 -- C5 to C6 there C7 levels results in mild reversal of cervical lordosis.There is no convincing evidence of cord signal abnormality.Uppermost visualized thoracic spine demonstrate a small disk protrusion at T3 -- T4 level. The finding results in effacement of the ventral subarachnoid space and the status of subtle flattening deformity of the thoracic cord with ultrasound for spinal stenosis or cord signal abnormality.
1.Examination demonstrates moderate degenerative changes of cervical spine with resultant mild reversal of cervical lordosis at C4 -- C5 through C6 -- C7 levels.2.There is mild central spinal stenosis only at C6 -- C7.3.Multi-level neuroforaminal compromise of varying degrees as detailed per level above.4.Sagittal images demonstrate a central disk protrusion at T3 -- T4 level with subtle flattening deformity of the cord however without spinal stenosis or neural foraminal compromise.