 There is straightening of the normal cervical lordosis. Vertebral body heights are grossly maintained. Anterior osteophytes are noted throughout the entire cervical spine along with moderate multilevel disc desiccation. There are no subluxations. There is a developmentally narrow cervical spinal canal due to shortened pedicles. There is intrinsic cord signal abnormality on sagittal and axial T2W imaging at the level of C6-C7 ventrally of which volume averaging/slice thickness limits full visualization of this region. There is no significant cord contour abnormality, volume loss, or expansion in this area.C1/2: There is widening of the atlantodental interval measuring up to 7 mm and mild basilar invagination with resulting narrowing of the foramen magnum. There is effacement of the ventral and dorsal thecal sac compatible with moderate canal stenosis. Both the posterior aspect of the dens and posterior arch of C1 appear to impinge on the spinal cord. There is no significant signal abnormality within the cord.C2/3: No significant canal stenosis. Minimal left uncovertebral hypertrophy causes minimal left neural foraminal stenosis.C3/4: A posterior disc-osteophyte complex and right uncovertebral hypertrophy cause moderate to severe canal stenosis and moderate right and moderate to severe left neural foraminal stenosis. There is no significant signal abnormality within the cord.C4/5: A small posterior disc-osteophyte complex and uncovertebral hypertrophy cause mild canal stenosis and moderate right and moderate to severe left neural foraminal stenosis. C5/6: A moderate posterior disc-osteophyte complex causes mild to moderate canal stenosis and moderate right and moderate to severe left neural foraminal stenosis. C6/7: Small posterior disc-osteophyte complex without significant canal stenosis. There is bilateral uncovertebral hypertrophy with moderate right and mild to moderate left neural foraminal stenosis. C7/T1: No significant canal or neural foraminal stenosis.On sagittal images, there is also a posterior disc-osteophyte complex at T1-T2 which causes mild canal stenosis and moderate, left greater than right, neural foraminal stenosis.
1. Widening of the atlantodental interval, measuring up to 7 mm, is grossly similar in degree compared to prior C-spine radiographs; dedicated flexion and extension imaging can be considered for further evaluation. 2. Intrinsic cord abnormality at the level of C6-C7 of which evaluation is limited secondary to volume averaging. MRI with gadolinium and additional thinner T2-weighted images through this level may be considered for further evaluation. 3. Multilevel degenerative spondylosis on a background of a developmentally narrowed cervical spinal canal. In particular, there is moderate spinal canal stenosis at C1/C2, moderate to severe spinal canal stenosis at C3/C4, and multilevel moderate to severe neural foraminal stenosis, with additional details as described above.