Clinical question: Loss of balance. Signs and symptoms: Loss of balance. Pre-and post-enhanced cervical spine MRI:Foramen magnum is unremarkable.C2 -- C3 is unremarkable.C3 -- C4 demonstrate advanced disk disease with significant loss of disk height, minimal grade 1 retrolisthesis, mild bilateral facet and ligamentum flavum hypertrophy. There is slight flattening and posterior displacement of the cord, mild central spinal stenosis, significant right and moderate left neural foraminal compromise.C4 -- C5 demonstrate mild disk disease and loss of disk height, mild bulging disk, mild ( L > R) facet and ligamentum flavum hypertrophy. Findings results in mild central spinal stenosis and severe left and moderate right neural foraminal compromise.C5 -- C6 demonstrate mild degenerative disk disease and mild bilateral facet and ligamentum flavum hypertrophy which is slightly more pronounced on the left. No central spinal stenosis however significant bilateral ( L>R) neural foramina compromise is detected.C6 -- C7 demonstrate moderate disk disease with loss of disk height, mild bilateral facet and ligamentum flavum hypertrophy bilaterally. There is no central spinal stenosis. Significant left and mild right neural foraminal compromise is present.C7 -- T1 demonstrate mild degenerative changes without neural foraminal or central spinal canal compromise.The signal intensity of the cord remains within normal.Post-enhanced images demonstrate no detectable abnormal enhancement of the cord or leptomeninges. There is however expected mild enhancement of hypertrophic changes of the spine.Pre-and post-enhanced thoracic MRI:There is normal anatomical alignment vertebral column. There is however significant exaggeration of thoracic lordosis in the upper thoracic spine centered approximately at T3 level. There is mild compression deformity of T3 without associated marrow signal changes or malalignment and consistent with a chronic process. There is no evidence of spinal canal compromise or stenosis at any level.The signal intensity of vertebral column is unremarkable.There is no significant neural foraminal compromise at any level. There is no detectable abnormal enhancement the vertebral column, thoracic cord or the leptomeninges. Perispinal soft tissues are unremarkable and without abnormal enhancement.
1.Pre-and post-enhanced MRI cervical spine demonstrate degenerative changes of cervical spine (most severe at C3 -- C4) with resultant moderate central spinal stenosis at C3 -- C4 and mild central spinal stenosis at C4 -- C5. There are also multilevel bilateral neural foraminal compromise (several significantly) as detailed per level above. Normal signal intensity of the cervical cord without abnormal enhancement. Mild expected enhancement of the degenerative changes of cervical spine however is noted.2.Pre-and post-enhanced thoracic spine demonstrate no abnormal enhancement. There is mild chronic compression deformity of T3 vertebrae without enhancement. There is exaggerated kyphosis of upper thoracic spine at T3 level disproportionate to mild chronic compression deformity of T3 as described above. There is no evidence of spinal canal or appreciable neural foramina compromise at any level. The signal intensity and the caliber of the thoracic cord is within normal.