55 years Female (DOB: 5/3/1960)Reason: myelopathy cord signal change? History: R hand numbness, neck painPROVIDER/ATTENDING NAME: JAMES M MOK JAMES M MOK The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. There is mild reversal of the normal cervical curvature. There is multilevel disc desiccation present. There is a 7 mm extra-axial and intradural nodule present adjacent to the spinal cord at the right lateral aspect of the spinal canal at the C2-3 level.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is a broad-based central disc protrusion which impresses on the ventral aspect of the thecal sac and partially effaces spinal fluid ventral to the spinal cord. Overall there is a mild degree of spinal stenosis resulting at this level. There is no compromise of the exiting nerve roots at this level.At C4-5 there is no significant compromise to the spinal canal. There are some uncovertebral osteophytes and disc material at the lateral recesses which mildly encroach on the exiting nerve roots.At C5-6 there is a disc bulge at this level associated with bilateral uncovertebral osteophytes resulting in effacement of spinal fluid ventral and posterior the spinal cord and overall a mild to moderate degree of spinal stenosis as well as encroachment of the exiting nerve roots.At C6-7 there is a central disc extrusion at this level associated with bilateral uncovertebral osteophytes resulting in effacement of spinal fluid ventral and posterior the spinal cord and overall a moderate degree of spinal stenosis. There is no significant compromise to the exiting nerve roots within the neural foramina at this level.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.
1.There are multilevel degenerative changes present in the cervical spine worse at C5-6 and C6-7 where there is mild to moderate spinal stenosis at C5-6 and moderate spinal stenosis at C6-7 as well as encroachment of the exiting nerve roots within the neural foramina at C5-6. There are degenerative changes present at other levels as well with milder degrees of neural foraminal encroachment.2.There is an extra-axial and intradural well-circumscribed nodule present within the spinal cana at C2-3l. Differential considerations include a schwannoma and less likely meningioma as well as in the appropriate clinical setting metastatic disease. An MRI with contrast would help further evaluate this.3.An email was sent to Dr Mok regarding the above findings.