Date : 00.00.00
sb/bv
Name of the Patient : Abc XyzSubhanlmn / M / 60 yrs.
Referred by : Dr. Abc Xyzlwalkar.
Examination : M.R.I. of the Cervical Spine.

CLINICAL PROFILE :

C/O neck pain with numbness in BUE and BLE and gait imbalance since 2 months.

EXAMINATION :

M.R.I. of the cervical spine was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted sagittal images.

5 mm thick T1 Weighted and Fast Scan (T2 *) axial images

3 mm T1 Weighted coronal images.

5 mm thick T1 Weighted sagittal images in flexion and extension.

OBSERVATION :

There is reduction in height and loss of water content of the cervical intervertebral discs.

Posterior disc bulges with posterior peridiscal osteophytes are noted at the C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7 levels. Indentation on the cervical spinal cord is noted at the C3-C4, C4-C5 and C5-C6 levels. There is also ligamentum flavum hypertrophy at these levels with resultant tight lumbar canal at these levels.

There is atrophy of the cervical spinal cord at the C1-C2 level. The cervical spinal cord at this level shows a hyperintense signal on the T2 Weighted images posteriorly (isointense to normal cord on the T1 Weighted images) suggesting cord ischemia/contusion/gliosis. The atlanto-dens interval measures approximately 1.0 mm in the neutral position and approximately 8.0 mm in flexion. It reverts back to normal position in extension suggesting a mobile atlanto-axial dislocation.

The upper cervical vertebral bodies show spotty fatty marrow changes. The joints of Luschka at the C5-C6 level on the left shows degenerative changes. The facet joints at the C3-C4, C4-C5 and C5-C6 levels also appear slightly hypertrophied.
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The visualized pre and paravertebral soft tissues are unremarkable.

IMPRESSION :

1. Mobile atlanto-dens subluxation with the atlanto-dens interval measuring approximately 8.0 mms in flexion and 1.0 mm in the neutral and extended positions.

2. Atrophy of the cervical spinal cord at the C1-C2 level with altered signal posteriorly as described may represent cord ischemia/contusion/gliosis in the given clinical setting.

3. Posterior disc bulges with posterior peridiscal osteophytes at the C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7 levels with ligamentum flavum hypertrophy at the C3-C4, C4- C5 and C5-C6 levels with a tight cervical canal at these levels.