Fig. 4
A 37-year-old female patient complaining of neck & shoulder pain with mJOA score = 16 (Mild grade). Conventional MRI: A Sagittal T2WI, B Sagittal T1WI C, D Axial T2WI at CV4/5 disc level, Sagittal DTI: E ADC map, F FA grayscale map G FA color map, H 3D tractography. A, B Sagittal T2WI A and sagittal T1WI B showing straightening of cervical curve with multilevel central and right para central disc protrusion opposite CV3/4 through CV5/6 more notably at CV4/5 encroaching upon sub arachnoid space; the condition is augmented by hypertrophied ligamentum flavum with 2ry canal stenosis more at CV4/5 level. 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 7 mm in size, no abnormal cord signal at T1WI (compressive cord myelopathy grade II). C, D Axial T2WI at CV4/5 disc level showing central and right para central disc protrusion seen 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 CV4/5 (represented by arrow) = 1.02 × 10–3 mm2/s compared to 0.94 × 10–3 mm2/s at non-compressive site. F Sagittal FA grayscale map showing low FA value at site of cord myelopathy (CV4/5) 0.56 (mild FA grade) compared to 0.8 at non-compressive site. G Sagittal FA color map showing indention of cord at FA color map with abnormal faint green color at site of cord myelopathy (CV4/5). H 3D tractography showing mixed color intensity at site of cord myelopathy (grade II)