Male, 78 years old, status post head injury, assess for cervical ligamentous injury. Reversal of the cervical lordosis is seen centered at C4-5. A grade 1 anterolisthesis of C4 relative to C5 also noted. Degenerative loss of vertebral body height is seen involving C4, C5 and C6 with corresponding degenerative endplate signal alteration.The spinal canal is narrowed due to degenerative disease beginning at C3-4 and continuing down to C5-6. The spinal cord is variably impinged through this region. There may be some vague increased cord T2 signal at C4-5 but this is equivocal.Mildly hyperintense STIR signal is evident within the interspinous spaces at C3-4 and C4-5. Elsewhere, the spinal ligaments and paraspinous soft tissues are unremarkable. Trace edema or fluid is seen along the prevertebral space at C3 and C4.C2-3: Facet arthropathy, left worse than right. Mild posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Mild left foraminal narrowing. C3-4: Facet arthropathy, left more than right. Posterior disc-osteophyte complex formation and ossification of the posterior longitudinal ligament, asymmetric to the left. Moderate spinal canal stenosis without significant cord deformation. Moderate left and mild right foraminal narrowing. C4-5: Posterior disc-osteophyte complex formation and ossification of the posterior longitudinal ligament. Severe spinal canal stenosis with cord impingement and flattening. Moderate to severe bilateral foraminal narrowing. C5-6: Posterior disc-osteophyte complex formation. Moderate spinal canal stenosis with slight cord deformation. Moderate to severe bilateral foraminal narrowing. C6-7: Facet arthropathy. Posterior disc-osteophyte complex formation. No significant spinal canal stenosis. Moderate to severe bilateral foraminal narrowing. C7-T1: No spinal canal stenosis or neuroforaminal narrowing.
1.No definite evidence of traumatic osseous injury.2.Mild signal abnormality within the interspinous spaces at C3-4 and C4-5 could represent mild ligamentous injury or strain. Hyperintense STIR signal along the prevertebral space at C3 and C4 is nonspecific, but given the lack of adjacent soft tissue swelling, may simply be degenerative in nature.3.Multilevel degenerative findings are seen which contribute to significant spinal canal compromise from C3-4 through C5-6. The spinal cord is most severely impinged at C4-5 where there may be some mild abnormal cord signal indicating either edema or myelomalacia.