Compressive myelopathy

Case contributed by Dr Bruno Di Muzio

Presentation

35-year-old male patient presents with 2 weeks of gait disturbance, bilateral upper limit sensory changes, spastic gait, and bilateral sustained clonus.

Patient Data

Age: 35-year-old

MRI Cervical spine

Modality: MRI

Straightening of the cervical spine lordosis. Vertebral bodies have normal height, signal, and alignment. 

C3/4: broad-based posterior disc osteophyte complex minimally flattening the cord. Disc-osteophyte complexes moderately to severely stenosing both intervertebral foramina at this level. 

C4/5: broad-based posterior disc osteophyte complex with a right paracentral extrusion compressing the cord. There are moderate canal stenosis and moderate increased cord signal on T2 at this level. Disc-osteophyte complexes moderately to severely stenosing both intervertebral foramina at this level. 

C5/6: broad-based posterior disc osteophyte complex touching the cord. Disc-osteophyte complexes moderately stenosing the intervertebral foramen on the left and severely on the right. 

C6/7: broad-based posterior disc osteophyte complex touching the cord. Disc-osteophyte complex mildly stenosing the intervertebral foramen on the right. 

The cord is otherwise unremarkable in calibre and appearance, with no abnormal enhancement. No abnormal flow-voids. Paravertebral soft tissues are unremarkable. 

Case Discussion

Multilevel disc disease and foraminal stenosis with canal stenosis and compressive myelopathy at C4/5.

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Case Information

rID: 48373
Case created: 3rd Oct 2016
Last edited: 20th Apr 2017
System: Spine
Tag: rmh
Inclusion in quiz mode: Included

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