Neck pain, bilateral arm pain. Positive Hoffmann left, and brisk reflexes on exam. Stenosis, foraminal C6-C7 planning surgical procedure. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is minimal retrolisthesis of C5 on C6. Alignment of the cervical spine is otherwise maintained. No abnormal signal within the cervical cord is appreciated.Diffuse T2 hyperintensity is noted involving the C6 vertebral body. There are multilevel degenerative changes with disc desiccation throughout, with particular disc height loss at the C5-C6 and C6-C7 levels. Degenerative changes are also noted at the left C3-C4 facet joint with associated bone marrow edema involving the posterior elements of C3 and C4 on the left. Multilevel degenerative changes, individual levels as below: C2-3: No significant compromise to the spinal canal or right neural foramina. Minimal left neural foraminal narrowing related to facet arthropathy.C3-4: There is a small central disc protrusion which effaces the ventral thecal sac and slightly indents the ventral cord in the midline. There is mild to moderate degree of spinal canal stenosis at this level. No significant right neural foraminal stenosis. There is mild left neural foraminal stenosis.C4-5: Minimal central disc protrusion abutting the ventral cord, dorsal thecal sac is patent. Minimal left neural foraminal narrowing. No significant right neural foraminal stenosis.C5-6: Disc osteophyte complex and ligamentum flavum thickening result in moderate spinal canal stenosis relatively worse on the right aspect. There is bilateral uncovertebral hypertrophy. There is moderate to severe right neural foraminal stenosis and mild left neural foraminal narrowing.C6-7: There is disc osteophyte complex, ligament of flavum thickening, and bilateral uncovertebral hypertrophy resulting in moderate right and severe left neural foraminal stenosis. There is moderate spinal stenosis, slightly greater to the left of the midline.C7-T1: No significant spinal canal or right neural foraminal stenosis. Mild to moderate left neural foraminal stenosis.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. There is a 1.8 cm T2 hyperintense right thyroid lobe nodule.
1. Multilevel degenerative changes in the cervical spine with moderate spinal canal stenosis at C5-C6 and C6-C7 levels. There is milder degree of stenosis at the C3-C4 level related to central disc protrusion.2. Multilevel neural foraminal stenosis which is moderate to severe on the right at C5-C6 and severe on the left at C6-C7.3. Prominent facet arthropathy at the left C3-C4 level with associated bone marrow edema.4. 1.8 cm right thyroid lobe nodule which can be further evaluated with ultrasound as clinically indicated.5. T2 hyperintensity diffusely involving the C6 vertebral body which may be related to an underlying lesion such as atypical hemangioma, but is nonspecific.