Fig. 5
A 65-year-old female patient complaining of severe neck pain with motor disability with mJOA score = 12 (Moderate grade). Conventional MRI: A Sagittal T2WI, B Sagittal T1WI C Axial T2WI at CV3/4 level D Axial T2WI at CV4/5 level, Sagittal DTI: E ADC map F FA map G FA color map H 3D tractography A, B Sagittal T2WI (A) and Sagittal T1WI (B) showing multilevel disc bulge at CV3/4 through CV5/6 disc levels were CV3/4 shows bulky diffuse disc bulge, CV4/5 diffuse disc bulge with centrally protruded component and CV5/6 diffuse disc bulge, encroaching upon the sub arachnoid space with narrowing of both neural exit foramen the condition is augmented by hypertrophied PLL with 2ry canal stenosis. Those disc levels seen mildly compressing the related portion of the cervical cord (2nd degree), with no abnormal cord signal at T2WI & T1WI (Grade I). C, D axial T2WI at CV3/4 (C) showing bulky diffuse disc bulge and at CV4/5 level (D) showing diffuse disc bulge those disc levels indenting the subarachnoid space and compressing the related cord with no abnormal cord signal at T2WI and T1WI (Grade I). E Sagittal ADC map showing: high ADC value at CV4/5 disc level (represented by arrow) = 1.6 × 10–3 mm2/s compared to 0.6 × 10–3 mm2/s at non-stenotic segments. F Sagittal FA grayscale map showing: low FA value at CV4/5 disc level = 0.47 (moderate grade) compared to 0.7 at non-stenotic segments. G FA color map showing indention of cord at FA color map with abnormal faint green color at CV4/5 level. H 3D tractography showing homogenous color and intact fiber tracts (grade I)