63-year-old male with neck pain and brisk right upper and lower extremity reflexes. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Minimal degenerative grade 1 anterolisthesis of C7 on T1 is noted. Alignment is otherwise maintained. Degenerative bone marrow signal is demonstrated in the vertebral body endplates of the mid to lower cervical spine. No focal worrisome bone marrow signal abnormality is identified.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina.C3-4: Mild posterior disc osteophyte complex, bilateral facet arthropathy and ligamentum flavum thickening contribute to mild spinal canal stenosis. Moderate, left greater than right, bilateral neural foraminal narrowing. C4-5: Moderate posterior disc osteophyte complex with a left paracentral and right foraminal component. There is moderate spinal canal stenosis. Bilateral facet arthropathy and uncovertebral hypertrophy. Severe right and moderate to severe left neural foraminal narrowing. C5-6: Posterior disc osteophyte complex. Moderate to severe spinal canal stenosis with indentation of the ventral spinal cord. Minimal T2 hyperintense signal is demonstrated in the right aspect of the cord at the C5-C6 level and minimal T2 hyperintensity is seen dorsally just caudal to it. Bilateral facet arthropathy and uncovertebral hypertrophy. Severe right and moderate to severe left neural foraminal stenosis.C6-7: Posterior disc osteophyte complex with moderate spinal canal stenosis. Bilateral mild facet arthropathy and uncovertebral hypertrophy. Moderate bilateral neural foraminal narrowing.C7-T1: Small posterior disc osteophyte complex slightly eccentric to the right. Bilateral facet arthropathy. Mild spinal canal stenosis. Moderate to severe bilateral neural foraminal narrowing.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Multilevel degenerative changes in the cervical spine with multilevel spinal canal stenosis, worst at the C4-C5 and C5-C6 levels. There is associated mild cord deformity. There is minimal cord signal abnormality at the C5-6 level. 2. Moderate to severe multilevel neural foraminal stenoses as detailed above.