New onset bilateral hand numbness over one month with cervical radiculopathy. Bilateral C5-C6 radiculopathy. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is grade 1 anterolisthesis of C3 on C4 measuring 4 mm. There is minimal anterolisthesis of C7 on T1. Alignment is otherwise maintained. Bone marrow signal is within normal limits. Subtle cord signal abnormality suspected at C3-C4. Cord signal and morphology is normal at the other levels.Degenerative changes are seen in the cervical spine as described below:C2-3: No significant compromise to the spinal canal or neural foramina. Partial effacement of the dorsal thecal sac related to ligamentum flavum thickening. Bilateral facet arthropathy.C3-4: There is moderate to severe spinal canal stenosis with mild flattening of the cord related to disc osteophyte complex including a central protrusion. Grade 1 anterolisthesis also contributes. There is mild right and moderate left neural foraminal stenosis. There is moderate degree of bilateral facet arthropathy with fluid distention involving the facet joints.C4-5: Small disc osteophyte complex and ligamentum flavum thickening contribute to mild spinal canal stenosis. There is also mild right neural foraminal narrowing. Bilateral facet arthropathy.C5-6: Minimal disc osteophyte complex. No significant compromise to the spinal canal or neural foramina. Mild facet arthropathy.C6-7: No significant compromise to the spinal canal or neural foramina. Mild facet arthropathy.C7-T1: No significant compromise to the spinal canal or neural foramina. Mild facet arthropathy.Paraspinous soft tissue structures appear within normal limits. Partially empty sella incidentally noted which can be normal variant in this age group.
1. Degenerative changes in the cervical spine particularly at the C3-C4 level, where anterolisthesis, disc osteophyte complex, and ligamentum flavum thickening contribute to moderate to severe spinal canal stenosis. There is subtle associated cord signal abnormality suspected at this level.2. There is mild right and moderate left neural foraminal stenosis at C3-C4 as well as mild spinal canal and mild right neural foraminal narrowing at C4-C5.