Clinical question: Evaluate for facet hypertrophy and spinal stenosis. Signs and symptoms: Significantly decreased are ROM. Nonenhanced cervical MRI:Foramen magnum is unremarkable other than mild ligamentous hypertrophy. Incidental note is made of a small foci of T2 hyperintensity within the pons consistent with patient's history of small vessel ischemic strokes.C2-C3 demonstrate degenerative changes without spinal stenosis or neural foraminal compromise.C3-C4 demonstrate moderate disc disease and loss of disc height, and minimal degenerative changes of posterior elements. There is result in moderate left neural foraminal compromise and no central spinal stenosis. There are anteriorly projecting hypertrophic spur.C4-C5 demonstrate moderate disease and loss of disc height, moderate left and mild right facet hypertrophic changes, mild bilateral ligamentum flavum hypertrophy. Constellation of changes results in mild left neural foraminal compromise and mild central spinal stenosis. Incidental note is made of a tortuous right vertebral artery that partially traverses the right neural foramina.C5-C6 demonstrate advanced loss of disc height, mild facet and ligamentum flavum hypertrophy. Mild central spinal stenosis and mild to moderate left neural foraminal compromise.C6-C7 demonstrate advanced disc disease and loss of disc height, moderate bilateral ligamentum flavum hypertrophy and mild facet disease and prominent (L>R) disc-osteophyte complex which results in mild flattening of the cord and complete effacement of subarachnoid with moderate central spinal stenosis. There is no detectable cord signal abnormality. There is also significant right and moderate left neural foraminal compromise at this level.C7-T1 demonstrate mild degenerative disc disease, moderate bilateral ligamentum flavum hypertrophy and moderate asymmetric right-sided facet hypertrophy. Constellation of changes result in mild central spinal stenosis and mild right neural foraminal compromise.Upper most visualized thoracic spine and cord is unremarkable other than degenerative changes.
1.At C6-C7 extensive degenerative changes results in moderate central spinal stenosis, significant right and moderate left neural foraminal compromise as detailed.2.Degenerative changes at other levels with resultant multilevel mild central spinal stenosis as detailed.3.Multilevel neural foraminal compromise as detailed per level above.4.No detectable signal abnormality of the cord.