Clinical question: Evaluate for cervical stenosis or foraminal stenosis. Signs and symptoms: LUE paresthesia and hyperreflexia. Nonenhanced cervical spine MRI:The alignment of the vertebral column is anatomical.There is uniform generalized small caliber of the cervical spinal canal which is believed to represent a congenital anatomic variation of the short pedicle.Foramen Magnum is unremarkable.C2 -- C3 is unremarkable.C3 the C4 is unremarkable.C4--C5 demonstrate mild degenerative changes with result in mild to moderate right neural foraminal compromise however without spinal stenosis or neural foraminal compromise. There is a tiny linear T2/T2 stir hyperintensity within the fundus of the disk in the midline and to the right consistent with a tiny annular fissure. This finding is best appreciated on sagittal T2 stir images 7 and 8 and axial T2 series 6 on image 21. C5 -- C6 demonstrate mild disk disease and loss of disk height. There is a tiny focus of T2 hyperintensity laterally on the right (sagittal T2 stir series 3 image 5 and axial T2 series 6 image 27) suspicious for small disk extrusion or annular fissure. There is moderate bilateral neural foraminal compromise secondary to degenerative changes. Mild degenerative changes at this level in combination with congenitally small canal results in mild central spinal stenosis at this level.C6 -- C7 demonstrate a small left lateral disk protrusion (sagittal T2 stir image 8 and axial T2 series 6 images 30 and 31). There is moderate left and mild right neural foramina compromise without central spinal stenosis.C7 -- T1 is unremarkable.Unremarkable signal intensity and caliber of cervical and uppermost visualized thoracic cord.
1.There is uniformly smaller caliber of the cervical spinal canal which represent a congenital anatomical variation.2.Mild degenerative changes at C5 -- C6 in combination with congenitally small canal results in central spinal stenosis only at this level.3.Tiny disk extrusion or annular fissure on the right at C5 -- C6 is noted.4.Shallow broad-based disk protrusion on the left at C6 -- C7 with moderate left neuroforaminal compromise.5.Multi-level neural foraminal compromise as detailed per level above.6.Normal signal intensity and caliber of cervical cord.