Compressive myelopathy

Case contributed by Dr Hoe Han Guan

Presentation

Neck pain and bilateral thenar muscle pain for 3 months.

Patient Data

Age: 65 years
Gender: Female
MRI

Multi-level diffuse disc osteodiscal complexes are seen from C3/C4 to C6/C7 levels, resulting in moderate to severe spinal canal stenosis.

Intramedullary hyperintensity on T2WI/STIR sequences noted within cervical spinal cord at the C4/C5 and C6/C7 levels.

Abnormal bone marrow signal intensity noted at the C6 and C7 vertebral bodies where hypointensity on T1WI and corresponding hyperintensity on T2WI and STIR sequences, in keeping with Modic type I changes.

Bilateral C6 neuroforamina are narrowed causing bilateral C7 exiting nerve roots to be compromised.

Case Discussion

Degenerative cervical spondylosis with multi-level neuro foraminal stenosis from C3/C4 till C6/C7 and compressive myelopathy at C4/C5 and C6/C7 levels.

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