Clinical question: Cervical stenosis? Signs and symptoms: Bilateral (R>L) shoulder pain, work injury. No unenhanced cervical MRI:Examination demonstrates no detectable post traumatic changes of the cervical spine and including soft tissues.The signal intensity of vertebral column demonstrates some changes secondary to degenerative disease.The alignment of cervical spine is anatomical.Foramen magnum is unremarkable.C2-C3 is unremarkable.C3-C4 demonstrate mild to moderate degenerative disc disease and loss of disc height, bilateral (L>R) uncovertebral hypertrophy and without appreciable facet or ligamentum flavum hypertrophy. Findings results in mild right and moderate left neural foraminal compromise without spinal stenosis.C4-C5 demonstrate mild to moderate disc disease and loss of disc height, bilateral uncovertebral hypertrophic changes without appreciable facet or ligamentum flavum degenerative/hypertrophic findings. Constellation of above findings results in mild central spinal stenosis, moderate right neural foraminal compromise.C5-C6 demonstrate mild to moderate disc disease and loss of disc height, bilateral uncovertebral hypertrophic spurs and no significant facet or ligamentum flavum hypertrophy. There is resultant mild central spinal stenosis, moderate right and severe left neural foraminal compromise.C6-C7 demonstrate mild disc disease and loss of disc height bilateral uncovertebral hypertrophic spurs and no significant degenerative changes of posterior elements (facets/ligamentum flavum). There is resultant moderate to severe bilateral (L>R) neural foraminal compromise.C7-T1 demonstrate mild degenerative changes without spinal canal and mild left neural foraminal compromise.The signal intensity and caliber of the cervical and upper most visualized thoracic cord is within normal.
1.Degenerative changes of the cervical spine primarily involving the disks with bilateral uncovertebral hypertrophic spurs without significant degenerative or hypertrophic changes of posterior elements.2.Above degenerative changes are detected at C3-C4 through C6-C7 levels with resultant bilateral (L>R) neural foraminal compromise of varying degrees at these levels.3.Mild central spinal stenosis also present at C3-C4 through C5-C6 levels however more conspicuous at C4-C5 level.4.There is normal signal intensity and caliber of the cervical and uppermost visualized thoracic cord.5.There is no evidence of posttraumatic findings.