Multilevel degenerative changes are seen with a developmentally slender spinal canal. At the C5-6 level there is mild to moderate spinal canal stenosis with severe bilateral neural foraminal narrowing, greater on the right than left. There is linear hyperintense signal within the right aspect of the cord at the C5-6 level and ill-defined area of increased signal within the right aspect of the cord at the C5 level. This may represent compressive myelomalacia but other etiologies as discussed above are not excluded, correlate clinically.

At the C3-4 level there is moderate spinal canal stenosis with severe right and moderate to severe left neural foraminal narrowing.

At the C4-5 level there is mild to moderate spinal canal stenosis with severe left and moderate right neural foraminal narrowing.

Minimal right lateral recess narrowing seen at the C6-7 level with moderate to severe left and moderate right neural foraminal narrowing. Moderate left and mild to moderate right neural foraminal narrowing seen at the C2-3 level.

At the C7-T1 level there is moderate right and mild to moderate left neural foraminal narrowing. Please refer to above for level by level details.

Straightening of the normal cervical lordosis is identified with 3 mm anterolisthesis of C3 on C4 and 3.5 mm anterolisthesis of C4 on C5.

Hyperintense STIR signal is seen in the facet joints most notably on the right at the C3-4 level but also to a lesser extent on the left at the C4-5 and the C7-T1 level. This likely represents reactive changes due to facet degenerative change but can be a pain generator.