Fig. 2
A 53-year-old male patient complaining of neck and shoulder pain with mJOA score = 14 (Moderate grade). Conventional MRI: A Sagittal T2WI, B Sagittal T1WI, C, D Axial T2WI at CV6/7 disc level, Sagittal DTI: E ADC map, F FA grayscale map, G FA color map, H 3D tractography. A, B Sagittal T2WI, A Sagittal T1WI, B showing straightening of cervical curve with uni-level diffuse disc bulge with central protruded component opposite CV6/7 encroaching upon sub-arachnoid space; the condition is augmented by hypertrophied ligamentum flavum with 2ry canal stenosis. This disc level is seen severely compressing the related portion of the cervical cord (3rd degree), with type I T2 hyperintense cord signal (white arrow) measuring about 10 mm in size, no abnormal cord signal at T1WI (compressive cord myelopathy grade II). C, D axial T2WI at CV6/7 disc level showing diffuse disc bulge with central protruded component indenting the subarachnoid space and compressing the related cord with T2 hyperintense signal (Grade II). E Sagittal ADC map showing high ADC value at site of cord myelopathy CV6/7 (represented by arrow) = 1.42 × 10–3 mm2/s compared to 0.8 × 10–3 mm2/s at non-compressive site. F Sagittal FA grayscale map showing low FA value at site of cord myelopathy (CV6/7) = 0.43 (moderate FA grade) compared to 0.63 at non-compressive site. G FA color map showing faint green color intensity of FA map at CV6/7 disc level. H 3D tractography showing homogenous color of the cervical cord and intact fiber tracts (grade I)