Left neck pain, muscle spasms, tension headaches, concern for cervical radiculopathy Craniovertebral junction appears within normal limits. There is minimal anterolisthesis of C2 on C3 and minimal retrolisthesis of C3 on C4 as seen on recent CT. Moderate degenerative changes are seen throughout the cervical spine with loss of intervertebral disc height, worst at the C3-C4 and to a lesser degree C5-C6 levels. The cervical vertebral bodies are appropriate in height. Bone marrow signal is benign with endplate signal changes involving C3 and C4 related to degenerative disease. There does appear to be progression of these changes at the intervertebral discs and endplates compared to MRI from 5/19/2009.The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: Mild disc bulge. No significant compromise to the spinal canal or neural foramina.C3-4: Loss significant loss of disc height with associated endplate marrow changes. There is a disc osteophyte complex with uncovertebral hypertrophy and a disc bulge eccentric to the right. There is mild spinal canal stenosis with effacement of the ventral thecal sac and mild indentation of the ventral cord. There is moderate right and mild left neural foraminal stenosis.C4-5: There is mild to moderate left and minimal right neural foraminal stenosis related to uncovertebral hypertrophy. No significant spinal canal narrowing.C5-6: There is disc bulge and bilateral uncovertebral hypertrophy resulting in moderate to severe right and moderate left neural foraminal stenosis. No significant spinal canal stenosis.C6-7: Minimal disc bulge and bilateral uncovertebral hypertrophy. There is mild to moderate bilateral neural foraminal stenosis. No significant spinal canal stenosis.C7-T1: Uncovertebral hypertrophy results in mild to moderate right neural foraminal narrowing. No significant left neural foraminal narrowing. No significant spinal canal stenosis. Facet arthropathy on the right.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Multilevel degenerative changes in the cervical spine which have progressed since 5/19/2009. There is mild spinal canal narrowing at C3-C4. Multilevel neural foraminal narrowing as detailed above, relatively worse at the right C3-C4 and bilateral C5-C6 levels.