Clinical question: Cervical spinal stenosis. Signs and symptoms: Neck symptoms. Nonenhanced MRI of cervical spine:Examination demonstrate advanced degenerative changes of cervical spine. Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate mild degenerative changes and unremarkable otherwise.C4 -- C5 demonstrate advanced disk disease with loss of disk height and partial disk fusion. Significant (left greater than right) neural foraminal compromise and no spinal stenosis.C5 -- C6 demonstrate advanced disk disease, significant loss of disk height and mild facet and ligamentum flavum hypertrophy. There is a moderate to severe left and mild to moderate right neural foraminal compromise and no central spinal stenosis.C6 -- C7 demonstrate advanced disk disease with significant loss of disk height, mild to moderate right and mild left hypertrophic changes of facets and ligamentum flavum. Findings results in significant bilateral neural foraminal compromise and mild central spinal stenosis.C7 -- T1 demonstrate advanced disk disease with significant loss of disk height, moderate left and mild to moderate right facet and ligamentum flavum hypertrophy. Constellation of changes results in significant bilateral (left greater than right) neural foraminal compromise and spinal stenosis. Degenerative changes also results in mild anterolisthesis at this level.T1 -- T2 demonstrate mild degenerative changes with resultant right neural foraminal compromise.There is suggestion of subtle increased T2 signal intensity of the cord at C7 without convincing evidence of change in cord caliber. Possibility of this observation representing an artifactual finding cannot be entirely excluded due to suboptimal images.The uppermost visualized thoracic spine to T4 level is unremarkable.
1.Extensive degenerative changes of cervical spine most significant at C4 -- C5 through C7 -- T1 levels.2.There is is some multi-level bilateral neural foraminal compromise (some significantly) as detailed parallel oblong. 3.Degenerative changes also results in mild central spinal stenosis at C6 -- C7 and C7 -- T1 levels.4.Suggestion of subtle increased cord T2 signal intensity without change in the caliber of the cord at C7 level which could also represent an artifactual finding due to suboptimal axial images.