Diffuse pain and weakness, evaluate for cervical or segmental cord compression. Examination is obtained per screening adult cord compression MRI protocol. There is 6 mm anterolisthesis of C7 on T1 with severe loss of intervertebral disk space and T2 hyperintensity within the disc space. There is low T1 and T2 signal involving the adjacent endplates compatible with sclerosis. There is moderate loss of height involving the anterior aspect of the T1 vertebral body and minimal loss of height involving the C7 vertebral body.There are degenerative changes throughout the cervical spine with disk osteophyte complexes and moderate spinal canal stenosis at C3-C4, C4-C5, C5-C6, and moderate to severe spinal canal stenosis at C7-T1. There is T2 hyperintensity within the cervical cord at the C7-T1 level. Advanced facet arthropathy is also seen at the C7-T1 level bilaterally. There is bone marrow edema which extends into the posterior elements at C7 and T1. There is severe neural foramina stenosis at C7-T1, worse on the right than the left.Remainder of the cervical, thoracic, and lumbar vertebral body heights appear preserved. There is straightening of the lumbar spine curvature. Advanced degenerative changes are noted at the L3-L4 and L4-L5 levels and to a lesser degree at L2-L3 and L5-S1. Axial images were not obtained, however, there may be up to moderate spinal canal stenosis. There is up to severe neural foraminal narrowing at the L3-L4, L4-L5, and L5-S1 levels.
Limited exam for cord compression protocol demonstrating degenerative changes throughout the cervical spine, worst at the C7-T1 level, where there is 6 mm of anterolisthesis, severe loss of intravertebral disk space, endplate sclerosis, and mild anterior wedging of the T1 vertebral body. These findings are most likely related to advanced degenerative changes. Given the advanced degenerative/destructive changes at the C7-T1 level described above including the anterior and posterior elements, Charcot/neuropathic joint can also be considered, although uncommon, in the appropriate clinical setting.Moderate to severe spinal canal stenosis at C7-T1 with T2 hyperintensity within the cord compatible with edema.Degenerative changes also noted in the lumbar spine, worst at the L3-L4 and L4-L5 levels. There is T2 hyperintensity within the disk space and adjacent endplates which may be on a degenerative basis. There may be up to moderate spinal canal stenosis which is difficult to evaluate without axial images. Due to the screening nature of this protocol details are not as evident on imaging as dedicated protocols of the spine. 