 Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. Abnormal cord signal intensity involves the dorsal aspect of the cervical cord at the C4/C5 level. Additionally, there is mild T2 hyperintensity extending inferiorly within the cervical cord to the approximate level of C6-C7. The cervicomedullary junction is normal. The visualized paraspinal contents are unremarkable.There are multilevel degenerative changes, individual levels as below:C2/3: No significant spinal canal stenosis or neuroforaminal narrowing. C3/4: There is minimal disc bulge and mild right sided uncovertebral hypertrophy. There is no significant spinal canal stenosis. There is mild to moderate right and mild left neuroforaminal narrowing.C4/5: There is a posterior disc osteophyte complex with bilateral uncovertebral hypertrophy with moderate bilateral neuroforaminal narrowing and moderate spinal canal stenosis. Cervical cord signal abnormality is maximal at this level as described above.C5/6: There is a small posterior disc osteophyte complex and bilateral uncovertebral hypertrophy with mild to moderate left and mild right neuroforaminal narrowing. There is mild spinal canal stenosis.C6/7: There is minimal posterior disc bulge with mild spinal canal stenosis. The neuroforamina are patent.C7/T1: No significant spinal canal or neural foraminal narrowing.
1. Abnormal T2 hyperintense signal involving the dorsal cervical cord from C4/C5 to C6/C7, greatest at C4/5. Differentials include subacute combined degeneration, given the dorsal column distribution of the signal abnormality. Inflammatory myelopathy is also high in the differential. Given the relatively higher grade of spinal canal stenosis at this level, compressive myelopathy also remains a consideration. Postcontrast imaging and brain imaging may be considered if an inflammatory process seems likely based on clinical findings and symptoms are of recent onset. 2. Multilevel degenerative changes with spinal canal and neural foraminal narrowing as detailed above. 