Spasticity, evaluate for cervical stenosis Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is osseous fusion involving the C3-C4 vertebral bodies and the C5-C6 vertebral bodies. There is minimal retrolisthesis of C5 on C6. Alignment is otherwise grossly maintained. Bone marrow signal is benign.Degenerative changes are seen in the cervical spine as described below:C2-3: There is mild right neural foraminal narrowing related to uncovertebral hypertrophy and facet arthropathy. No significant compromise to the spinal canal or left neural foramen.C3-4: There is a subligamentous disc extrusion with approximately 6 mm superior migration. There is at least moderate spinal canal stenosis at this level with complete effacement of the ventral and dorsal thecal sac and subtle impression on the cord. There is questionable subtle T2 hyperintensity within the cord at this level.C4-5: Fusion at the intervertebral discs level. There is a small dorsally projecting osteophyte which results in mild spinal canal stenosis at this level. Mild left and minimal right neural foraminal narrowing.C5-6: There is a disc osteophyte complex and ligamentum flavum thickening which contribute to moderate to severe spinal canal stenosis at this level and deformity of the cord particularly in its right aspect. There is T2 hyperintensity in the cord and volume loss consistent with myomalacia. There is severe right and moderate left neural foraminal stenosis related to uncovertebral hypertrophy and to a lesser degree facet arthropathy.C6-7: Fusion at the intervertebral disc level. No significant spinal canal stenosis. There is mild left and minimal right neural foraminal stenosis. C7-T1: There is a disc osteophyte complex and bilateral uncovertebral hypertrophy. There is mild spinal canal stenosis at this level. There is mild to moderate bilateral neural foraminal stenosis.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Postsurgical changes of remote anterior cervical fusion with solid osseous fusion evident at C4-C5 and C6-C7. 2. There is moderate to severe spinal canal stenosis at the C5-C6 level which is not fused. There is cord deformity at this level particularly on the right. There is also T2 hyperintensity and volume loss consistent with myelomalacia.3. There is also at least moderate stenosis at the C3-C4 level related to disc extrusion with superior migration. There is questionable subtle T2 signal abnormality at this level.4. Multilevel neural foraminal stenosis, worst at the C5-C6 level where there is severe right-sided neural foraminal stenosis. Additional levels as above.