I wonder if someone can explain this recent MRI of CERvical spine?

[RAMOM14]

1. Moderate spondylitic changes of the cervical spine, worst at the C5-C6 level, with moderate
severe spinal canal stenosis secondary to posterior disc osteophyte complex, disc extrusion, and
posterior ligamentous hypertrophy, resulting in moderate severe stenosis with underlying cord
compression and signal abnormality, consistent with mild cervical cord myelomalacia. NO additional
moderate severe spinal canal stenosis or cord signal abnormality detected.
2. Multilevel foraminal stenosis secondary to facet and uncinate hypertrophy with severe LEFT-sided
C5-C6 and C6-C7 foraminal stenosis.
3. NO compression fractures or aggressive osseous lesions are seen.
4. NO erosive changes seen to suggest active inflammatory spondylarthritis. Normal predental space.

Narrative
DATE OF SERVICE: 05.02.2018
CLINICAL INDICATION:54 years-old Female with Cervicalgia. Bilateral arm pain. History of rheumatoid
arthritis.
TECHNIQUE:
This MR study consists of multiple sagittal and axial images of the cervical spine utilizing T1, T2
acquisitions, was performed utilizing a 3 Tesla closed system.
COMPARISON: Cervical radiographs, 4/12/2018.
FINDINGS:
Motion limited MR of the cervical spine.
ANATOMY: Conventional cervical spine anatomy.
ALIGNMENT: Mild straightening and reversal of the normal cervical lordosis. Trace anterolisthesis of
C4 on C5. Minimal RETROlisthesis of C5 on C6. Normal predental space. Normal C1-C2 alignment.
OSSEOUS STRUCTURES: NO compression fractures or aggressive osseous lesions seen. Homogeneous marrow
signal. Mild prevertebral spurring seen at C4, C5-C6. NO odontoid erosive changes seen to suggest
active inflammatory spondylarthritis.
FACET JOINTS: Mild diffuse facet arthritis, worst at C4-C5 and C5-C6.
CERVICAL CORD: Abnormal cervical cord signal seen at the C5-C6 level, with evidence of compressive
myelopathy measuring 6 mm in craniocaudal extent, image 10, series 402. NO additional areas of
abnormal cervical cord signal or detected. NO evidence of cervical cord expansion or atrophy.
INTERVERTEBRAL DISCS: Moderate loss of disc height and disc signal seen at C5-C6 and C6-C7.
Otherwise, mild loss of disc height and disc signal.
CRANIOCERVICAL JUNCTION: Intact.
SOFT TISSUES: NO prevertebral soft tissue thickening/edema. NO paraspinal fluid collection or mass
is seen.Mild heterogeneity of the thyroid gland with asymmetric enlargement of the RIGHT thyroid
lobe. NO large/dominant thyroid nodules identified. Mild paranasal sinus inflammatory changes seen
in the inferior maxillary sinuses.
CERVICAL FLOW VOIDS:The visualized major cervical vascular signal voids are intact. Dominant RIGHT
cervical vertebral artery.
CERVICAL LEVELS:
C2-C3: NO significant foraminal or spinal canal stenosis is identified.
C3-C4: Mild disc bulge. NO significant foraminal or spinal canal stenosis is identified.
C4-C5: Mild disc bulge with a shallow central disc protrusion. Mild LEFT foraminal stenosis from
facet and uncinate hypertrophy. NO significant RIGHT foraminal or spinal canal stenosis is
identified.
C5-C6: There is a broad-based posterior disc osteophyte complex and disc bulge, with a RIGHT
paracentral disc extrusion, demonstrating mild caudal migration, measuring 6 mm. There is moderate
severe spinal canal stenosis, with flattening of the cervical cord, narrowed to approximately 5.7 mm
AP. There is contributing moderate posterior ligamentous and facet hypertrophy. There is severe LEFT
foraminal stenosis from uncinate and facet hypertrophy. There is moderate RIGHT foraminal stenosis.
C6-C7: There is a mild broad-based posterior disc osteophyte complex, with mild posterior
ligamentous and facet hypertrophy. There is severe LEFT foraminal stenosis from uncinate and facet
hypertrophy. There is mild spinal canal stenosis.