Acute neck pain. Cervical spine shows minimal reversal of the normal lordosis. Vertebral body heights are preserved. Marrow signal shows mild heterogeneity but no suspicious focal lesion. Intervertebral discs show moderate height and severe T2 signal loss at all levels associated with endplate irregularity and osteophytesThe spinal cord shows normal signal. It is minimally indented by disc-osteophyte complexes as described below.C1-C2: Fluid signal posterior and superior to the dens is probably degenerative in nature and causes mild ventral indentation of the thecal sac.C2-C3: Disc osteophyte complexes along with left facet and right uncovertebral proliferative change results in moderate biforaminal stenosis. The central canal is preserved.C3-C4: The disc-osteophyte complex is slightly eccentric to the right. It is associated with right uncovertebral proliferative change. It results in mild-to-moderate canal narrowing and severe right and moderate left foraminal stenoses. There is also ligamenta flava thickening at this level.C4-C5: Disc osteophyte complex is eccentric to the right and contributes to mild to moderate canal narrowing as well as severe right and moderate left foraminal stenoses. Ligamenta flava thickening is also present.C5-C6: Disc osteophyte complex and right more than left uncovertebral productive changes result in severe right and moderate left foraminal stenoses. There is no significant canal stenosis. Ligamenta flava thickening is also present.C6-C7: Disc osteophyte complex and uncovertebral proliferative change cause mild-to-moderate right and moderate left foraminal stenoses. There is no significant central stenosis.C7-T1: Disc osteophyte complex causes severe right and moderate to severe left foraminal stenoses. There is no significant central stenosis.T1-T2: Facet proliferative change causes severe left and moderate right foraminal stenoses. There is also ligamenta flava thickening.Prominent central T2 hyperintensity in the pons may reflect small vessel ischemic change, of undetermined age.
Multilevel degenerative disc/osteophyte disease as well as uncovertebral and facet proliferative change and ligamenta flava thickening cause variable (moderate to severe) foraminal stenoses that are worse on the right. They also cause central canal narrowing that is most pronounced at C3-C4 where it is mild-to-moderate.