65F with right-sided neck pain radiating up to ear/down to shoulder, no specific injury, no muscle spasms on exam, fails to respond to muscle relaxants and exercises, flex-ex imaging negative for instability, ?facet pathology, ?nerve impingement Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is maintained. Bone marrow signal is within normal limits. The cervical spinal cord has normal signal characteristics and overall morphology.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: No significant compromise to the spinal canal or neural foramina.C4-5: Small disc osteophyte complex with uncovertebral hypertrophy. There is also mild ligamentum flavum thickening. There is mild spinal canal stenosis. There is mild to moderate right and minimal left neural foraminal stenosis.C5-6: Small central disc protrusion and mild ligamentum flavum thickening. There is minimal narrowing of the spinal canal. No significant neural foraminal stenosis.C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.There is fairly mild generalized facet arthropathy affecting the cervical spine. The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
Mild multilevel degenerative changes in the cervical spine, relatively worse at the C4-C5 level where there is mild spinal canal stenosis and mild to moderate right-sided neural foraminal stenosis.