Male, 78 years old, with neck pain and left arm radicular symptoms. Trace retrolisthesis of C3 relative to C4, and C6 relative to C7 are demonstrated. Endplate irregularity and edema is seen at most levels compatible with degeneration. Otherwise, vertebral body morphology is unremarkable.Multiple small chronic strokes are seen within the cerebellum. Details of the cervical spinal cord will be discussed by level as follows:C2-3: Left facet hypertrophy. Mild posterior disk osteophyte formation. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing. No spinal cord abnormality.C3-4: Right worse than left facet hypertrophy. Significant posterior disk osteophyte formation, asymmetric to the right. Severe spinal canal stenosis with flattening and impingement of the spinal cord. Mild increased T2 signal within the cord at this level and slightly below along with cord thinning. Moderate left and severe right foraminal narrowing.C4-5: Mild facet hypertrophy. Mild posterior disk osteophyte formation. No significant spinal canal stenosis or cord abnormalities. Moderate bilateral foraminal narrowing. C5-6: Mild facet hypertrophy. Moderate posterior disk osteophyte formation with mild generalized spinal canal narrowing but no significant cord impingement. Severe left and moderate right foraminal narrowing. C6-7: Mild facet hypertrophy. Moderate posterior disk osteophyte formation causing mild/moderate generalized spinal canal stenosis and slight cord flattening. Moderate bilateral foraminal narrowing. C7-T1: Facet hypertrophy. Minimal central disk protrusion. No significant spinal canal stenosis. Moderate right and mild left foraminal narrowing.
Multilevel cervical spondylosis, most severely affecting the C3-4 level where a disk osteophyte complex, in combination with posterior element hypertrophy, results in significant spinal canal stenosis with cord impingement. The cord is thinned and T2 hyperintense at this level which favors myelomalacia, though some component of superimposed edema cannot be excluded.Less significant spinal canal stenosis, and variable foraminal narrowing, are also seen as discussed above.