Cervical Spine MRI Report Template: Normal and Degenerative Examples

A complete normal cervical MRI report

This framework assumes a routine cervical spine MRI without intravenous contrast. State the actual sequences, contrast use, coverage, comparison, and limitations. A normal template is appropriate only after the corresponding anatomy has been reviewed.

Clinical note: MRI findings should be interpreted with the clinical history and examination. A normal cervical MRI does not exclude every cause of neck pain, radiculopathy, or myelopathy.

Examination: MRI of the cervical spine without intravenous contrast.

Technique: Multiplanar, multisequence images of the cervical spine were obtained.

Comparison: [Date and examination / None available].

Findings: Cervical alignment and vertebral body heights are maintained. Marrow signal is within expected limits. The craniocervical junction is unremarkable. Intervertebral disc heights and signal are preserved. No focal disc herniation or significant spinal canal or neural foraminal stenosis is identified from C2-C3 through C7-T1. The cervical spinal cord is normal in caliber and signal. No significant abnormality is identified in the prevertebral or paraspinal soft tissues.

Impression: No significant abnormality of the cervical spine on MRI.

Adjust “within expected limits” and every negative statement to the patient, field of view, and image quality. If the examination is focused or technically limited, describe what was and was not assessed.

A fixed review sequence

1. Confirm scope and numbering

Check the indication, side if relevant, contrast protocol, sequences, field of view, motion, and prior imaging. Confirm that the craniocervical junction and cervicothoracic junction are included. Use a reliable localizer or available whole-spine reference to number levels when anatomy is transitional or the cervicothoracic junction is not fully shown. State uncertainty rather than implying exact numbering.

2. Alignment, vertebrae, and marrow

Review the craniocervical relationship, cervical lordosis, translation, and curvature. Assess vertebral body height, endplates, posterior elements, and marrow. If there is scoliosis, listhesis, fracture, focal marrow replacement, or postoperative change, document its level and relevant extent.

3. Discs, canal, and cord

At each disc level, describe the disc contour and any disc-osteophyte complex, then state its effect on the ventral thecal sac, spinal canal, and cord. Report cord caliber and signal separately. Do not turn a small bulge into “stenosis” without showing the degree of narrowing and the affected structure.

4. Neural foramina and posterior elements

Assess right and left neural foramina at each level, including uncovertebral and facet hypertrophy where present. Describe side and severity when narrowed. Review facet joints, ligamentum flavum, and visible posterior soft tissues.

Level-by-level worksheet

Use the level labels only after confirming the numbering method. A concise worksheet prevents a missed level; it does not require repetitive prose when all levels are normal.

C2-C3: Disc / canal / right foramen / left foramen.
C3-C4: Disc / canal / right foramen / left foramen.
C4-C5: Disc / canal / right foramen / left foramen.
C5-C6: Disc / canal / right foramen / left foramen.
C6-C7: Disc / canal / right foramen / left foramen.
C7-T1: Disc / canal / right foramen / left foramen.

For an abnormal level, name the morphology, side, degree of narrowing, and neural structure affected. For example, “left uncovertebral osteophyte causes moderate left neural foraminal narrowing” is more useful than “degenerative change.”

Common degenerative wording

Degeneration is common and should be described without assuming it causes the symptoms. Separate disc height or signal loss from canal and foraminal effects.

C5-C6: Mild disc height loss with a broad disc-osteophyte complex, mildly narrowing the spinal canal without cord deformation or cord signal abnormality. Uncovertebral osteophytes cause moderate right and mild left neural foraminal narrowing.

This wording reports the level, morphology, and neural effect. If there is cord flattening, severe stenosis, or cord signal abnormality, state it directly and ensure the impression reflects the finding.

Fictional worked example

The following is a fictional teaching case, not reusable patient text. A patient with neck pain and right arm paresthesia has mild multilevel degeneration, greatest at C5-C6. The images show no cord signal change.

Examination: MRI of the cervical spine without intravenous contrast.

Comparison: None available.

Findings: Cervical alignment is maintained. Vertebral body heights are preserved. Mild disc desiccation is present at C4-C5 and C5-C6. At C4-C5, a small broad-based disc-osteophyte complex mildly narrows the ventral subarachnoid space without cord contact. At C5-C6, a broad disc-osteophyte complex mildly narrows the canal and causes moderate right and mild left neural foraminal narrowing. No cord deformation or abnormal cord signal is identified. The remaining cervical levels show no significant canal or foraminal stenosis. The craniocervical junction and included paraspinal soft tissues are unremarkable.

Impression:
1. Mild cervical spondylosis, greatest at C5-C6, with moderate right neural foraminal narrowing.
2. No spinal cord compression or signal abnormality.

The impression highlights the most relevant finding and answers the likely neural-compression question without declaring that the imaging finding explains the symptoms.

Reporting checklist

• Correct patient, examination, contrast protocol, and comparison
• Cervical and cervicothoracic junction coverage
• Reliable vertebral numbering and explicit uncertainty if needed
• Alignment, vertebral heights, marrow, and endplates
• Disc morphology at every level
• Central canal and cord effect at every abnormal level
• Right and left foramamina assessed separately
• Cord caliber and signal
• Relevant posterior elements and visible soft tissues
• Impression states the most important level and neural effect

Wording and protocol pitfalls

• “Normal” despite mild degeneration: name the finding and its effect rather than calling the entire examination normal.
• Unspecified “foraminal narrowing”: indicate the level and side; grade severity only when supported by the images.
• Assumed numbering: transitional anatomy or limited coverage can shift level labels. Record the method or limitation.
• Cord signal overinterpretation: describe the signal and location; avoid assigning a cause from a routine noncontrast study alone.
• Overstated exclusion: a routine cervical MRI is not a dedicated vascular, peripheral nerve, or dynamic instability examination.
• Contrast mismatch: infection, tumor, inflammatory disease, and postoperative questions may require a tailored protocol. Do not use a routine noncontrast template as if those questions were fully assessed.

For current imaging selection, see the ACR Appropriateness Criteria® for Cervical Pain or Cervical Radiculopathy (opens in a new tab). The report sequence should also follow local standards for spine MRI and communication of significant findings.

For a related lumbar framework and phrase bank, see Normal Lumbar Spine MRI Report and Common Reporting Phrases for Lumbar Spine MRI. These related pages do not replace cervical level labels or cord review.

References

• American College of Radiology. ACR–ASNR–SABI–SSR Practice Parameter for the Performance of MRI of the Adult Spine (opens in a new tab).
• American College of Radiology. ACR Appropriateness Criteria®: Cervical Pain or Cervical Radiculopathy (opens in a new tab), revised 2024.
• American College of Radiology. Practice Parameter for Communication of Diagnostic Imaging Findings (opens in a new tab).

This educational framework does not replace patient-specific interpretation, the current local protocol, or clinical judgment.