66-year-old male with bilateral upper/lower extremity weakness and paresthesias. Evaluate for cord signal abnormality. C-Spine MRI:There is straightening of the cervical spine. The vertebral body heights are maintained. There is multilevel disc height loss most prominently involving the C4-5 and C5-6 levels. There is no worrisome focal marrow signal abnormality. There is cord T2 signal abnormality posterior to C4, posterior to C5 and to a milder degree posterior to C3 which is likely secondary to long standing spinal canal narrowing from disc disease. The vertebral artery flow voids appear to be intact. The paraspinous soft tissue structures appear within normal limits.Interspace observations:C2-3: Small disc osteophyte complex. No significant compromise to the spinal canal or neural foramina.C3-4: Disc osteophyte complex and small superimposed central disc protrusion. Facet arthropathy. Mild-moderate neuroforaminal narrowing and mild to moderate spinal canal stenosis.C4-5: Prominent disc osteophyte complex. Facet arthropathy and ligamentum flavum thickening. Severe spinal canal stenosis. Moderate right and moderate to severe left neuroforaminal narrowing. C5-6: Disc osteophyte complex. Moderate spinal canal stenosis. Moderate right and moderate to severe spinal canal stenosis. C6-7: Small disc osteophyte complex. Facet arthropathy. Minimal left neuroforaminal narrowing. No right neuroforaminal or spinal canal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.Cord compression protocol:Cervical spine findings as described above. Within the thoracic and lumbar spine, the spinal cord has normal signal characteristics and overall morphology. There are mild degenerative changes and multi-level Schmorl's nodes involving the lower thoracic and lumbar spine.
1.Cord signal abnormality in the cervical spine which likely reflects myelomalacia in association with likely long-standing spinal canal narrowing and cord impingement from degenerative changes and disc disease.2.Multi-level degenerative changes in the cervical spine with severe spinal canal narrowing involving the C4-5 level which also has moderate right and severe left neuroforaminal narrowing.3.Evaluation of the thoracic and lumbar spine were performed for exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. No cord compression is identified in the thoracic or lumbar spine.