Clinical question: Neck pain. Signs and Symptoms: Back and neck pain. Nonenhanced cervical MRI:There is post operative changes of an anterior cervical fusion spanning C5 through C7.There is maintained normal anatomical alignment however with mild straightening of cervical lordosis.Foramen magnum is unremarkable.C2-C3 demonstrate mild degenerative changes, minimal left uncovertebral hypertrophy with minimal left neural foraminal compromise(axial T2 series 6 image 22) and no spinal stenosis. C3-C4 demonstrate mild degenerative changes with mild asymmetric right uncovertebral hypertrophic changes (Axial T2 series 6 images 30 through 33) with resultant moderate right neural foramen.C4-C5 demonstrate post operative changes of anterior fusion and without neural foraminal or spinal stenosis.C5-C6 demonstrate postoperative changes of an anterior fusion without central spinal stenosis or neural foraminal compromise.C6/C7 demonstrate post operative changes of anterior fusion, mild asymmetric left uncovertebral hypertrophy with resultant very subtle compromise of the left neural foramen. There is mild flattening of the ventral aspect of cord secondary to shallow ventral hypertrophic changes without convincing central spinal stenosis. Patent right neural foramen.C7-T1 demonstrate mild disc degeneration, mild loss of disc height and mild bulge with slight flattening of the ventral aspect of the cord. There is also mild symmetrical bilateral ligamentum flavum and facet hypertrophy. No central spinal stenosis or definitive neural foraminal compromise.T1-T2 is unremarkable.There is a trace vertical linear T2 stir hyperintense in the anterior cervical cord at C6 and C7 levels without change in cord caliber which conceivably could represent myelopathy.
1.Postoperative changes of anterior fusion spanning C4-C7. 2.No central spinal stenosis at any level.3.Multilevel neural foraminal compromise; mild left neural foraminal at C2-C3, moderate right neural foraminal at C3-C4 and subtle left neural foraminal compromise at C6-C7 levels as detail above.4.Trace linear T2 STIR hyperintensity of the cord at C6 and C7 could conceivably represent myelopathy.