Case 5

This is a CT cervical spine study showing dense, confluent, linear, almost continuous ossification posterior to the vertebral bodies of C2 to C4, and second, smaller linear, almost continuous ossification extending from C5 to C6. This indicates ossification of the posterior longitudinal ligament. The ossification is centred to the left side, and is causing cervical canal stenosis and significant narrowing at the left lateral recess of the spinal canal (particularly at C3/4 level) with encroachment on the exiting nerve root.

There is also moderate degenerative cervical spine disease, as indicated by multilevel reduced intervertebral disc space, lipping osteophytes, facet joint osteo-arthropathy, and significant bony narrowing of the right C6/7 intervertebral foramen.

I would obtain an MRI cervical spine study in the first instance to assess the severity of spinal cord compression and myelopathy.

I would then discuss the case with the referring physician as this patient might require urgent decompression.