Persistent neck pain not relieved by physical therapy Examination is mildly motion degraded. Craniovertebral junction appears within normal limits. The cervical vertebral bodies are appropriate in height. There is minimal anterolisthesis of C4 on C5 and minimal retrolisthesis of C5 on C6 and C6 on C7. There is also mild anterolisthesis of C7 on T1. Bone marrow signal is benign. The cervical spinal cord has normal signal characteristics and overall morphology.Degenerative changes are seen in the cervical spine as described below:C2-3: Small central disc protrusion. No significant compromise to the spinal canal or neural foramina.C3-4: Minimal disc osteophyte complex and ligamentum flavum thickening contributing to mild spinal canal stenosis. Neural foramina are patent. C4-5: Disc osteophyte complex with uncovertebral hypertrophy and right-sided facet arthropathy. There is mild spinal canal stenosis. There is moderate to severe right neural foraminal stenosis. Left neural foramen is patent.C5-6: Disc osteophyte complex with bilateral uncovertebral hypertrophy and facet arthropathy, worse on the right than the left. There is severe right and moderate left neural foraminal stenosis. Fairly mild spinal canal narrowing.C6-7: Disc osteophyte complex and ligamentum flavum thickening contributing to mild spinal canal stenosis. Uncovertebral hypertrophy and bilateral facet arthropathy contribute to moderate bilateral neural foraminal stenosis.C7-T1: Disc uncovering related to grade 1 anterolisthesis and ligamentum flavum thickening contribute to mild spinal canal stenosis. There is mild left and moderate to severe left neural foraminal stenosis related to facet arthropathy.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits. Diffuse opacification of the bilateral mastoid air cells.
1. Multilevel degenerative changes throughout the cervical spine with mild degree of spinal canal stenosis from the C3-C4 to the C7-T1 levels, relatively worse at the C3-C4, C6-C7 and C7-T1 levels. No cord signal abnormality. There is also significant multilevel neural foraminal stenoses as detailed above. 2. Diffuse opacification of the bilateral mastoid air cells.