Female, 82 years old, with upper right arm pain and right-sided neck pain. A chronic type II odontoid fracture is evident with approximately 4 mm anterior subluxation of the fracture fragment relative to the rest of the C2 vertebral body. The fracture and its orientation are unchanged when compared to prior CT exams.Straightening of the cervical lordosis is seen, but otherwise, the sagittal alignment is within normal limits. The cervical vertebral bodies demonstrate diffuse loss of height which is likely degenerative in nature. Marrow signal characteristics are heterogeneous, again likely degenerative in nature. No worrisome marrow replacement or marrow edema is observed.Except as discussed below, the visualized spinal cord is normal signal intensity and morphology. No epidural abnormalities are suspected.C1-2: Likely due to the subluxed odontoid process fracture, the posterior arch of C1 appears to be mildly anteriorly shifted. This results in a moderate generalized narrowing of the spinal canal with mild flattening of the dorsal and ventral spinal cord. No evidence of cord edema is seen.C2-3: Mild posterior disc-osteophyte complex formation. No significant spinal canal or foraminal stenosis. C3-4: Posterior disc-osteophyte complex formation. Mild spinal canal narrowing without cord deformation. Mild bilateral foraminal narrowing. C4-5: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate bilateral foraminal narrowing. C5-6: No significant spinal canal or foraminal stenosis. C6-7: Mild posterior disc-osteophyte complex formation. No significant spinal canal or foraminal stenosis. C7-T1: Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Facet hypertrophy contributes to mild left foraminal narrowing.
1.A chronic type II odontoid fracture is seen. Anterior subluxation of the fracture fragment and the C1 arch results in a moderate generalized spinal canal narrowing at the C1-2 level with deformation of the cord but no evidence of cord edema.2.Elsewhere, multilevel cervical spondylosis is seen resulting in mild spinal canal narrowing as discussed above.