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Cervical Disk Hernia_2

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Short summary

62-year-old male underwent an MRI scan of the cervical spine. The expert's conclusions from this test are: congenital diffuse cervical spinal stenosis together with disc protrusion and Ligamentum flavum hypertrophy with evidence of myelopathy at the level of C3-4.

Medical Background
 
Patient's History
 
MRI of the cervical spine performed on the 1/08.
I have reviewed the images on the 5/08.
Technique: TSE, T1, T2, STIR, done in all planes.
                  Images are suboptimal probably due to patient's habitus and distance
                  from the coil.
 
Findings:
The craniocervical junction is within normal limits.
There is diffuse contributory cervical spinal canal stenosis.
At the C3-4 level there is a large central disc protrusion with ligamentum flavum hypertrophy, both causing severe canal stenosis with faint high T2 signal within the cord consistent with myelopathy .
At the C4-5 level there is diffuse disc bulge with mild to moderate spinal Stenosis and right foraminal stenosis due to right uncovertebral joint degeneration, causing right foraminal stenosis. There is linear high T2 signal at that level suggestive of myelopathy.
At the C6-7 level, there is diffuse disc bulge with uncovertebral joint Degeneration with moderate spinal stenosis and bilateral formainal Stenosis, worst on the right.
 
Medical opinion
 
Conclusion:
Congenital diffuse , cervical spinal stenosis.
Severe stenosis at C3-4 level secondary to disc protrusion and Ligamentum flavum hypertrophy with evidence of myelopathy.
Mild- moderate stenosis at C4-5 with myelopathic signal within the right cord at that level, suggestive of a dynamic mechanism.
Moderate spinal stenosis at C6-7 and significant foraminal stenosis.