Clinical question: Evaluate for stenosis. Signs and symptoms: Neck pain. Nonenhanced cervical MRI:Foramen magnum is unremarkable.C2-C3 is unremarkable with the exception of mild degenerative changes.C3-C4 demonstrate mild degenerative changes with mild right-sided asymmetric uncovertebral hypertrophy resulting in moderate right neural foraminal compromise and unremarkable otherwise.C4-C5 demonstrate mild degenerative changes without spinal stenosis or neural foraminal compromise.C5-C6 demonstrate advanced disc disease with loss of disc height and mild bilateral facet and ligamentum flavum hypertrophy. There is a disc-osteophyte complex on the left with resultant mass effect, flattening and posterior displacement or on the left. There is moderate central spinal stenosis, moderate left neural foraminal compromise and patent right neural foramen. There is interval resolution of a right para median disc protrusion since prior exam and resultant slight interval improvement of central spinal stenosis.C6-C7 demonstrate advanced disc disease and loss of disc height, mild facet and ligamentum flavum hypertrophy with resultant mild central spinal stenosis. There is however interval decreased disc bulge or disc protrusion at this level since prior exam with resultant mild improvement of spinal stenosis(axial T2 series 901 images 16 through 18). Severe right and moderate left neural foraminal compromise demonstrate no significant interval change.C7-T1 demonstrate mild degenerative changes however without spinal stenosis or neural foraminal compromise.There is a tiny central anterior cord linear T2 hyperintensity (axials T2 series 901 images 16 through 20 concerning for myelopathy.
1.Extensive degenerative changes at C5-C6 and C6-C7 levels with resultant central spinal stenosis as detailed. There is mild interval improvement of central spinal stenosis however secondary to decreased right paracentral disc protrusion since prior exam and decreased bulging disc at C6-C7. Neural foraminal compromise at both these levels demonstrate no significant change2.No central spinal stenosis at any other level.3.Neural foraminal compromise as detailed per level above.4.Tiny linear T2 hyperintensity of cord concerning for myelopathy at C6 and C7 levels.