Fig. 6
A 42-year-old female patient complaining of neck pain & motor disability with mJOA score = 14 (Moderate grade). Conventional MRI: A Sagittal T2WI and B Sagittal T1WI C Axial T2WI at CV4/5 level D Axial T2WI at CV5/6 level, Sagittal DTI: E ADC map, F FA grayscale map G FA color map and H 3D tractography. A, B sagittal T2WI (A) and sagittal T1WI (B) showing straightening of cervical curve with multilevel bulky diffuse osteophytic disc complex bulge at CV4/5 through CV6/7 disc levels with central protruded component at those levels, encroaching upon the related portion of 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 are seen indenting the related portion of the cervical cord (2nd degree), more at CV4/5 with type II T2 hyperintense cord signal (white arrow) measuring about 11.5 mm in size, no abnormal cord signal at T1WI (compressive cord myelopathy grade II). C, D Axial T2WI at CV4/5 (C) and at CV5/6 (D) showing bulky diffuse osteophytic disc complex bulge with central disc protrusion at those disc levels encroaching upon the subarachnoid space and indenting the related portion of the cord with abnormal high T2 cord at CV4/5 level (Grade II). E Sagittal ADC map showing a higher ADC value at site of cord myelopathy CV4/5 (represented by arrow) = 1.16 × 10–3 mm2/s compared to 1 × 10–3 mm2/s at non-compressive site. F Sagittal FA grayscale map showing a lower FA value at site of cord myelopathy (CV4/5) 0.52 (mild FA grade) compared to 0.74 at non-compressive site. G FA color map showing subtle indention of cord at CV4/5 disc level with faint green color intensity. H 3D tractography showing mixed color intensities at site of cord myelopathy (grade II)