Clinical question: cervical radiculopathy to explain neck pain and posterior headacheSigns and Symptoms: headache, neck painComments: 77 yo male with severe neck pain and posterior headache, although with DJD of thoracic, lumbar spine | The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. No abnormal enhancing lesions are identified in the cervical spine. There is reversal of the normal cervical curvature present. There is multilevel disc desiccation present.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. Small uncovertebral osteophytes are present at this level.At C4-5 there is no significant compromise to the spinal canal. There is loss of disc space height at this level. There are endplate and uncovertebral osteophytes present at this level associated with encroachment of the exiting nerve roots within the neural foramina bilaterally. There are large anterior osteophytes present at this level.At C5-6 there is is loss of disc space height at this level. There are endplate and uncovertebral osteophytes present at this level associated with encroachment of the exiting nerve roots within the neural foramina bilaterally. There is ligamentum flavum hypertrophy present at this level There is effacement of spinal fluid ventral and posterior the spinal cord at this level with partial effacement of spinal fluid ventral and posterior the spinal cord. Overall there is a mild to moderate degree of spinal stenosis at this level. There are large anterior osteophytes present at this level.At C6-7 there is no significant compromise to the spinal canal. There is loss of disc space height at this level. There are endplate and uncovertebral osteophytes present at this level associated with encroachment of the exiting nerve roots within the neural foramina bilaterally. At C7-T1 there is no significant compromise to the spinal canal. There is loss of disc space height at this level. There are endplate and uncovertebral osteophytes present at this level associated with mild encroachment of the exiting nerve roots within the neural foramina bilaterally. The vertebral artery flow voids appear to be intact.
1.There are are degenerative changes present in the cervical spine with multilevel encroachment of exiting nerve roots bilaterally at C4-5, C5-6 and C6-7 and mild to moderate spinal stenosis present at C5-6.