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This is a patient who had cervical myelopathy.

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And on the Sagittal T two weighted scans,

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we can see that there are areas of high signal

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intensity in the cervical spinal cord,

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opposite the C3-C4 level

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and the C4-C5 level. And general,

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there is loss of volume in the spinal cord,

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indicating that this is a chronic process

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with myelomalacia. As you can see,

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there are multiple levels in which there

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appears to be a mild degree of narrowing

0:30

of the cervical spinal canal.

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However, I wanted to demonstrate, in this case, the

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impact of degenerative changes of the Luschka joints.

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So when we come to the Luschka joints,

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we're usually looking at the

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neuroforaminal levels,

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and I'm just going to add the localizer here.

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So when you look down at the C3-C4 level,

0:54

for example,

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what one sees is a neuroforamen which

0:58

shows relatively normal width on the left side.

1:01

However, we have this overgrowth of bone on the right side,

1:06

which is causing neuroforaminal narrowing.

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In addition, you have a little bit of overgrowth of the

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facet joint on the right side at the C3-C4

1:14

level. So as with the central spinal canal,

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we grade the neuroforamina in terms of mild,

1:21

moderate mark, depending upon whether

1:23

we think it's one third narrow,

1:24

one-third to thirds narrow, or greater than two

1:26

thirds narrowed, respectively. In this case,

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I would call this moderate to severe narrowing

1:33

of the right neural foramen.

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Let's go down one level below to the C4-C5 level.

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At the C4-C5 level, we again are seeing that the

1:45

neuroforamina are quite narrowed.

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Here you are at the pedicle level.

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Here's the other pedicle level.

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All we get is this little strip of high-signal-intensity

1:55

space through the neuroforamina bilaterally.

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So this would be severe narrowing on the left side

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and moderate to severe.

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It looks a little bit better on

2:06

the right side. And again,

2:08

this is not secondary to bright signal

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intensity disc herniation.

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This is all bone from spurring

2:15

of the uncovertebral joints.

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If we continue downward to the next level,

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which is C5-C6,

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you have posterior osteophyte formation

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and then on the right side,

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you really don't see very much good

2:30

foramen at the C5-C6 level.

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A little bit over here on the contralateral

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side. Again, narrowing.

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This is all from uncovertebral joint degenerative change.

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The facet joints actually don't look all that

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bad. They don't look that hypertrophied.

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But what we're seeing is this irregular bone

2:48

from the patient's uncovertebral joint.

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We continue down to the C6-C7 level,

2:54

looks a lot better.

2:56

This is only minimally narrowed.

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On the right side, we got a lot more space.

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And if we continue down to the next level below,

3:04

again, we're seeing a lot better foramina

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at C6-C7 and C7-T1.

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So demonstration of the use of gradient echo

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scans to determine bony narrowing

3:17

of the neuroforamina,

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largely on the basis of uncovertebral joint

3:21

or luschka joint degenerative change.