Clinical question: Foraminal narrowing, disc disease? Signs and symptoms: Pain down right shoulder. Nonenhanced cervical spine MRI:Examination demonstrates advanced degenerative disc disease with significant loss of intervertebral disc height at multiple levels and mild reversal of cervical lordosis. The alignment of vertebral column however remains anatomic.Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes with subtle left neural foraminal compromise and unremarkable otherwise.C3-C4 demonstrate moderate to severe disc disease and loss of disc height, small bilateral uncovertebral hypertrophic changes and mild facet and ligamentum flavum hypertrophy. Constellation of changes results in moderate to severe left and severe right neural foraminal compromise and mild central spinal stenosis.C4-C5 demonstrates moderate to severe disc disease and loss of disc height, large left and smaller right uncovertebral hypertrophic spur and mild facet and ligamentum flavum degenerative changes. Constellation of changes results in flattening and posterior displacement of the cord without central spinal stenosis and severe left neural foraminal compromise.C5-C6 demonstrate advanced disc disease and near complete loss of disc height, small bilateral uncovertebral hypertrophic changes and small central disc/osteophyte complex, mild left facet and bilateral ligamentum flavum hypertrophy. Constellation of changes and including central disc-osteophyte complex results in flattening and posterior displacement of the cord, moderate central spinal stenosis, moderate to severe right and moderate left neural foraminal compromise.C6-C7 demonstrate advanced disc disease and loss of disc height, central disc-osteophyte complex, bilateral uncovertebral hypertrophic changes and mild bilateral ligamentum flavum hypertrophy. Constellation of findings and including central disc-osteophyte complex results in flattening and posterior displacement of the cord and moderate central spinal stenosis. Severe bilateral neural foraminal compromise is also detected.C7-T1 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.T1-T2 demonstrate advanced disc disease and loss of disc height without spinal stenosis however moderate to severe bilateral neural foraminal compromise are identified.
1.Extensive degenerative changes of cervical spine at C3-C4 through C6-C7 levels and including disc osteophyte complex at C5-C6 and C6-C7 levels as detailed.2.Moderate Central spinal stenosis at C5-C6 and C6-C7 levels are noted.3.There is also multilevel bilateral neural foraminal compromise (some severely) as detailed per level above.4.T1-T2 demonstrate degenerative disc disease, loss of disc height and bilateral neural foraminal compromise without central spinal stenosis.