Ear and neck pain. There is a small focus of T2 hyperintensity along the medial aspect of the right occipital condyle-C1 junction favored to represent synovial cyst, but without mass effect on the cervical cord or medulla. Craniovertebral junction appears otherwise within normal limits. The cervical vertebral bodies are appropriate in height. Alignment is grossly maintained aside from minimal anterolisthesis of C3 on C4 and retrolisthesis of C5 on C6. 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: No significant compromise to the spinal canal or neural foramina.C3-4: Minimal disc osteophyte complex including uncovertebral hypertrophy. There is advanced left-sided facet arthropathy which contributes to moderate to severe left-sided neural foraminal stenosis. No significant compromise to the spinal canal or right neural foramen.C4-5: Disc osteophyte complex including uncovertebral hypertrophy and left facet arthropathy. Mild ligamentum flavum thickening. There is moderate to severe left neural foraminal stenosis. There is mild narrowing of the spinal canal and mild right neural foraminal narrowing. C5-6: Small disc osteophyte complex including uncovertebral hypertrophy as well as ligamentum flavum thickening. There is also left-sided facet arthropathy. There is mild spinal canal stenosis. There is moderate to severe left neural foraminal stenosis. Mild to moderate right neural foraminal stenosis. There is mild effacement of the left lateral aspect of the thecal sac at the C6 level related to a T1 and T2 hyperintense focus which may represent a small bony or perhaps soft tissue spur.C6-7: Minimal disc bulge without significant spinal canal or neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact. Paraspinous soft tissue structures appear within normal limits.
1. Multilevel degenerative changes in the cervical spine primarily consisting of left-sided facet arthropathy, worst at the C3-C4 level, and associated with moderate to severe left-sided neural foraminal stenosis at the left C3-C4, C4-C5, and C5-C6 levels.2. Mild spinal canal stenosis at the C4-C5 and C5-C6 levels. No high-grade spinal canal stenosis or evidence of cord signal abnormality.3. Small T2 hyperintense focus along the medial aspect of the right occipital condyle-C1 junction favored to represent synovial fluid/cyst without mass effect on the medulla or cervical cord.