Clinical question: Weakness and pain in UE. Signs and symptoms: As above. Nonenhanced cervical MRI:There is normal anatomical alignment of cervical spine however with mild grade 1 anterolisthesis at C7-T1.There is moderate degenerative changes of the discs and posterior elements throughout the cervical spine and including uniform and diffuse hypertrophic changes of posterior longitudinal ligament.Constellation of above findings results in moderate to severe central spinal stenosis at C3-C4, C4-C5, C5-C6 levels and mild central spinal stenosis at C6-C7 level. No spinal stenosis and C7-T1 level.Degenerative changes also results in moderate right neural foraminal compromise at C3-C4, severe right and mild left neural foraminal compromise at C4-C5, significant left and mild right neural foraminal compromise at C5-C6 and significant left and moderate to significant right neural foraminal compromise at C6-C7 levels. Although there is mass effect and flattening deformity of the cord at the levels of spinal stenosis there is no detectable signal abnormality of the cervical or the upper most visualized thoracic cord.Unremarkable images at the level of foramen magnum and mild degenerative changes at C2-C3 level.
1.Extensive degenerative changes of cervical spine and including diffuse posterior longitudinal ligament hypertrophy results in moderate to severe central spinal stenosis at C3-C4, C4-C5, C5-C6 levels and mild stenosis at C6-C7 level.2.Multilevel moderate to significant bilateral neural foraminal compromise as detailed per level above.3.No detectable cervical or upper most visualized thoracic cord signal abnormality.4.Mild grade 1 anterolisthesis at C7-T1 level likely due to degenerative disease.