Female, 79 years old, with neck pain, signs of radiculopathy. Assess for spinal stenosis, DJD or any other structural process. Spinal alignment is grossly anatomic. Vertebral body heights are preserved. No concerning marrow replacement or marrow edema is seen.The spinal canal is congenitally slender. Superimposed upon this are central and left paracentral disc osteophyte complexes at C2-3 through C6-7 which result in spinal cord impingement and significant generalized spinal canal stenosis. At the C2 level, there is a focus of myelomalacia within the left posterior cord which may reflect chronic impingement from the adjacent thickened posterior atlantoaxial ligament. No other areas of cord signal abnormality are demonstrated.C2-3: Left facet arthropathy. Left paracentral disc osteophyte which impinges upon the spinal cord. No significant generalized spinal canal stenosis. No significant foraminal narrowing.C3-4: Left facet arthropathy. Broad posterior disc-osteophyte complex formation with central focality which impinges and deforms the spinal cord and causes a significant generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. C4-5: Posterior disc-osteophyte complex formation with left paracentral focality which impinges on the cord and causes a significant generalized spinal canal stenosis. Severe bilateral foraminal narrowing. C5-6: Posterior disc osteophyte complex formation with left paracentral focality which impinges on the cord and causes a significant generalized spinal canal stenosis. Severe bilateral foraminal narrowing. C6-7: Posterior disc-osteophyte complex formation which moderately narrows the spinal canal. Severe left foraminal narrowing. C7-T1: No spinal canal stenosis or neuroforaminal narrowing.
Disc osteophyte disease, superimposed on a congenitally slender spinal canal, causes significant spinal canal stenosis through most of the cervical region. Focal disc osteophytes also impinge upon the spinal cord to varying degrees.A focus of myelomalacia is evident within the dorsal spinal cord at the C2 level. This likely represents sequelae of chronic impingement from the adjacent posterior ligaments which are thickened or buckled. Elsewhere, the spinal cord is free of significant signal abnormality.Foraminal narrowing is most notable bilaterally at C4-5, bilaterally at C5-6 and on the left at C6-7.