Date : 00.00.00
Name of the Patient : Abc Xyzshidlmn / M / 78 yrs.
Referred by : Dr. Abc Xyzni.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
C/O neck pain radiating to the BUE with paresthesias since 6 months.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
SOME IMAGES SHOW PATIENT MOTION.
There is loss of normal cervical curvature.
A large posterior disc herniation with posterior peridiscal osteophytes is seen at the C3-C4 level with anterior compression of the spinal cord. There is superior and inferior migration of the disc posterior to the C2 and C4 vertebrae. The spinal cord at this level shows a hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to the cord on the T1 Weighted images and is suggestive of cord edema/ischemia. The C3-C4 facet joints show hypertrophic degenerative changes with ligamentum flavum hypertrophy and a resultant tight canal at this level.
There is a posterior and right postero-lateral disc herniation at the C5-C6 level and a posterior disc herniation at the C6-C7 level with anterior indentation of
the cord and mild bilateral neural foraminal narrowing, right more than left at the C5-C6 level. There is mild left neural foraminal narrowing also at the C6-C7 level. The spinal cord at the C5-C6 and C6-C7 levels shows subtle hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images. This is isointense to the cord on the T1 Weighted images representing cord edema/ischemia. The C5-C6 facet joints bilaterally show degenerative changes.
A small posterior disc bulge is noted at the C4-C5 level and postero-central disc protrusion at the C7-D1 level with anterior indentation of the thecal sac. There is mild left neural foraminal narrowing at the C6-C7 level. Anterior disc herniations are noted at the C5-C6 and C6-C7 levels. The cervical intervertebral discs show loss of water content.
Fatty changes are seen in the cervical vertebral bodies.
The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region and the cervico-medullary junction are unremarkable.
The MRI features are suggestive of :
1. A large posterior disc herniation with posterior peridiscal osteophytes at the C3-C4 level with cord compression and cord edema/ischemia at this level with canal stenosis.
2. A posterior and right postero-lateral disc herniation at the C5-C6 level and posterior disc herniation at the C6-C7 level with cord edema/ischemia at these levels and tight canal.