New cervical pain, positive Spurling sign Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is reversal of cervical lordosis. Alignment of the cervical spine is otherwise maintained. Bone marrow signal is benign. The cervical spinal cord has normal signal characteristics and overall morphology. There is mild generalized facet arthropathy.Degenerative changes are seen in the cervical spine as described below:C2-3: Small central disc protrusion with partial effacement of the ventral thecal sac. No significant compromise to the spinal canal or neural foramina.C3-4: Central and left paracentral disc protrusion with effacement of the ventral thecal sac. No significant compromise to the spinal canal or neural foramina.C4-5: Left paracentral disc protrusion which effaces the ventral thecal sac and mildly indents the left ventral cord. Dorsal thecal sac is patent at this level. Mild bilateral neural foraminal narrowing.C5-6: There is a disc bulge which effaces the ventral thecal sac and extends into the left neural foramen. The disc bulge indents the ventral cord. Dorsal thecal sac remains patent. There is moderate left and mild right neural foraminal stenosis.C6-7: Mild disc bulge. No significant spinal canal or neural foraminal stenosis. C7-T1: No significant compromise to the spinal canal or neural foramina. Small perineural cysts incidentally noted.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. Opacification of the bilateral mastoid air cells noted.There appears to be a large soft tissue structure involving the visualized retropharyngeal soft tissues in the midline and extending to the level of the right carotid space with mass effect. There appears to be signal loss on the STIR sequence.
1. Degenerative changes in the cervical spine with multilevel disc bulges and disc protrusions, which along with kyphotic angulation of the spine result in impression on the ventral cord. Dorsal thecal sac remains patent. No evidence of high-grade spinal canal stenosis in the cervical spine or cord signal abnormality.2. There is moderate left C5-C6 neural foraminal stenosis. There is mild bilateral C4-C5 and mild right C5-C6 neural foraminal stenosis.3. Partially imaged large mass involving the visualized retropharyngeal soft tissues. There is intrinsic T1 hyperintensity with signal loss on the sagittal STIR sequence suggesting this is a lipoma. However would recommend obtaining a dedicated neck CT or neck MRI for better assessment and exclude other etiologies.4. Opacification of the bilateral mastoid air cells.