77 year old male with stenosis. Evaluate for cause of myelopathy. There is mild reversal of the cervical lordosis secondary to the fusion. Postsurgical changes are visualized of a C3-C5 anterior cervical discectomy and fusion. There is grade 1 anterolisthesis of C4 on C5. There is high T2 signal within the cord posterior to the C4 level which is likely chronic. The craniovertebral junction appears within normal limits. The bone marrow signal is within normal limits.Degenerative changes are seen in the cervical spine as described below:C2-3: There is a disc bulge and prominent ligamentum flavum hypertrophy causes moderate to severe central spinal canal stenosis. There is also mild to moderate bilateral neural foraminal stenosis.C3-4: There is uncovertebral and facet hypertrophy which causes moderate to severe bilateral neuroforaminal stenosis. There is mild central spinal canal stenosis.C4-5: There is uncovertebral and facet hypertrophy which causes severe bilateral neuroforaminal stenosis. There is mild central spinal canal stenosis.C5-6: There is a tiny disc bulge and uncovertebral and facet hypertrophy which causes mild to moderate central canal and neuroforaminal stenosis.C6-7: There is a mild disc bulge and uncovertebral and facet hypertrophy which causes severe the left and moderate right bilateral stenosis. There is mild central canal stenosis.C7-T1: There is a disc bulge with a right paracentral disc protrusion which abuts the thecal sac and causes moderate right neuroforaminal stenosis.On sagittal imaging, there is a mild disc bulge at T1-T2 and T2-T3 but no significant spinal canal stenosis.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1.Postsurgical changes from an anterior cervical discectomy and fusion from C3 to C5 with grade 1 anterolisthesis of C4 on C5.2.Multilevel cervical spine degenerative changes. There is at most moderate to severe central canal stenosis at the C2-C3 level and severe neuroforaminal stenosis involving the C4-5, C5-6 and C6-7 levels.3.T2/STIR signal hyperintensity posterior to the C4 vertebral body favors chronic myelomalacia.