Female, 50 years old, with weakness and numbness as well as neck pain. Straightening of the cervical lordosis is likely positional. Sagittal alignment is unremarkable. Vertebral body height and morphology are within normal limits. No pathologic marrow replacement, edema or enhancement is seen.The spinal canal is congenitally slender. Superimposed upon this are spondylotic changes particularly at C3-4, C4-5 and C5-6. Particularly at C3-4, the spinal cord is impinged with faint T2 signal abnormality. Elsewhere, cord signal intensity is within normal limits.C2-3: No spinal canal stenosis or neuroforaminal narrowing. No interval changes.C3-4: Large posterior disc osteophyte asymmetric to the right paracentral region. Significant spinal canal compromise with impingement of the cord. No significant foraminal narrowing. Findings have progressed.C4-5: Small central disc osteophyte complex which slightly indents the ventral cord. No significant generalized canal stenosis. Mild left foraminal narrowing. Findings have progressed.C5-6: Posterior disc-osteophyte complex formation asymmetric to the left paracentral zone where it slightly indents the ventral cord. No significant generalized canal stenosis although the lateral recess is narrowed on the left. Mild bilateral foraminal narrowing. Findings have progressed.C6-7: No spinal canal stenosis or neuroforaminal narrowing. No interval changes.C7-T1: No spinal canal stenosis or neuroforaminal narrowing. No interval changes.
Multilevel cervical spondylosis is seen. C3-4 is the most severely affected level where there is a central and right paracentral disc osteophyte which impinges on the cord with evidence of mild cord edema or myelomalacia. Smaller disc osteophytes are evident at C4-5 and C5-6.