Right arm radicular pain with extension of to the neck, assess for cervical spinal instability Cervical vertebral body heights are normal. There is exaggerated cervical lordosis as seen previously. There is mild osseous irregularity involving the cranial aspect of the odontoid process which is minimally progressed since prior study from 2009. There is small amount of fluid at the anterior atlantoaxial joint which is similar to prior. No evidence of cranial settling. Alignment of the craniocervical junction is preserved.Motion degradation slightly limits evaluation. No cord signal abnormality is appreciated. There are moderate multilevel degenerative changes throughout the cervical spine. There is mild progression of endplate degenerative changes at the C6-C7 level compared to 2009.Individual levels as described below:C2-3: No significant compromise to the spinal canal or neural foramina. Left-sided facet arthropathy.C3-4: Small disc bulge and mild bilateral facet arthropathy. No significant compromise to the spinal canal or neural foramina.C4-5: Small disc bulge and bilateral facet arthropathy, relatively worse on the left. No significant compromise to the spinal canal or neural foramina.C5-6: There is a disc osteophyte complex with ligamentum flavum thickening contributing to mild spinal canal stenosis at this level. There is facet arthropathy on the left with which contributes to moderate left and minimal right neural foraminal narrowing C6-7: There is a disc osteophyte complex, ligamentum flavum thickening, and facet arthropathy. There is mild to moderate spinal canal stenosis. There is a moderate to severe right and moderate left neural foraminal stenosis.C7-T1: No significant compromise to the spinal canal. Mild bilateral neural foraminal narrowing. Mild bilateral facet arthropathy.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 which have slightly progressed since prior study from 5/18/2009. There is moderate to severe right C6-C7 neural foraminal stenosis which may be contributing to patient's described arm symptoms. Additional levels as above. No high-grade spinal canal stenosis.2. Mild osseous irregularity involving the odontoid process with mild fluid involving the anterior C1-C2 joint. These findings may be related to degenerative disease or history of rheumatoid arthritis and minimally worse since 2009. Craniocervical junction alignment is preserved on the supine MRI. Flexion-extension radiographs however may be helpful to assess for instability.