Clinical question: Evaluate stenosis. Signs and symptoms: Neck pain. No unenhanced cervical MRI:Examination demonstrates normal anatomical alignment of vertebral column and stable since prior study.Foramen magnum is unremarkable and stable since prior exam.C2-C3 demonstrate moderate disc disease and loss of disc height and minimal ligamentum flavum hypertrophy. Mild central spinal stenosis, significant bilateral (L>R)neural foraminal compromise without significant change since prior exam.C3-C4 demonstrate advanced disc disease and loss of disc height, significant broad-based bulging disc without spinal stenosis however with significant bilateral neural foraminal compromise and stable since prior study. There is evidence of posterior laminectomy at this level similar to prior exam.C4-C5 demonstrate advanced disc disease with significant loss of disc height, prior posterior laminectomy and expansion of thecal sac without spinal stenosis. Significant bilateral neural foraminal compromise without change since prior exam.C5-C6 demonstrate advanced disc disease and loss of disc height, prior posterior laminectomy, expansion of thecal sac and no central spinal stenosis similar to prior study. Significant bilateral neural foraminal compromise similar to prior exam.C6-C7 demonstrate moderate disc disease and loss of disc height, large central disc protrusion with resultant mass effect and posterior displacement of the cord and severe central spinal stenosis with interval worsening since prior study. There is no convincing evidence of cord signal abnormality at this level. C7-T1 demonstrate mild disc disease and hypertrophic changes of posterior elements without spinal stenosis however moderate bilateral neural foraminal compromise is present.There is revisualization of a stable localized myelomalacia of the cord and decreased cord caliber at C5 level.Upper most visualized thoracic cord and spine is unremarkable.
1.Degenerative changes at C6-C7 with resultant severe central spinal stenosis and interval worsening since prior exam. Bilateral neural foraminal compromise as detailed.2.Stable focus of cord myelomalacia at C5 and no detectable focus of signal abnormality of the cord otherwise.3.Mild Central spinal stenosis at C2-C3 without change since prior exam.4.Stable postoperative changes of multilevel laminectomy at C3 to C6 levels with expansion of the spinal canal and no central spinal stenosis.5.Multilevel bilateral neural foraminal compromise (mostly of significant degree) without significant change since prior exam.