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Abstract Cervical spondylosis is a very common progressive disorder of the spine. It leads to major disability if left untreated. Presence of abnormal spinal cord signal on conventional MRI indicates either reversible or irreversible parenchymal changes of the spinal cord. Advanced MRI techniques as diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are studied to test their ability for early detection of myelopathic cervical spinal cord changes, to support decision making about conservative and surgical management options. Diffusion tensor imaging can assess spinal cord microstructure by tracing diffusion of water molecules. The diffusion indices; fractional anisotropy (FA), apparent diffusion coefficient (ADC) and diffusivity, are attributed to the spinal cord nerve fiber membranes. Changes in diffusion parameters reflect microstructural nerve damages (demyelination or axon damage). Previous studies found that there is a decrease in fractional anisotropy (FA) on diffusion tensor imaging (DTI) of the cervical spinal cord at areas of cord myelopathy. Some studies correlated the changes in fractional anisotropy and ADC value with the clinical severity of myelopathy and suggested its value in detecting early myelopathic changes before they appear on conventional T2 weighted images. Our cross-sectional study included 50 patients with cervical spondylosis and brachialgia 19-78 years of age. Clinical assessment was done using the Neurosurgical Cervical Spine scale (NCSS). MRI examination was performed on 1.5 |