MRI
Axial T2
Sagittal T1
Sagittal T2
The patient has had previous surgical intervention at C6/7 by way of anterior discectomy and fusion. There has been reasonable decompression of the spinal canal at this level, however, the cord is atrophic and contains foci of increased T2 signal at the level of the C6/7 disc on either side of midline (snake eye appearance) together with further similar abnormal T2 signal within the cord at the level of the C6 vertebral body. Appearances are indicative of compressive myelomalacia.
At C5/6 (level above surgery) there is substantial canal stenosis due to broad-based disc bulging producing at least moderately severe cord compression. A central disc protrusion at C4/5 also causes moderate anterior cord encroachment.
At C3/4 there is gross central disc extrusion with very severe cord compression. Subtle cord parenchymal T2 brightening indicative of oedema. This is a very substantial finding and will likely require surgical intervention.