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Have radicular neck pain. Taken epidural injections. MRI showed mild canal stenosis from broad posterior disc. What to do?

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Spine Surgeon
Practicing since : 2002
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I have radicular neck pain. How long should I wait before deciding that I should get surgery. I have no arm weakness. I have had pain for about 5 weeks. Epidural injections help temporarily....3-4 days with limited pain. Can tolerate the pain, but very limited about activity. Can't even swim. It is a C5 radiculopathy, pain into scapula and deltoid muscles.

MRI: mild canal stenosis from broad posterior disc osteophyte complex as well as moderate-severe foraminal narrowing. Moderate facet hypertrophy.

Also have noticed some very mild balance issues over the past year after a fall of a ladder. (Ended up with an Achilles tendon rupture and repair and thought balance may be related to that ankle injury....but could it be related to the canal stenosis?

Questions: operation necessary? what type of operation? Just opening the foramen or larger operation?
Posted Sun, 28 Jul 2013 in Back Pain
Answered by Dr. Rahul D Chaudhari 2 hours later
thanks for writing to us.
You have very valid questions.
When we are talking about cervical disc prolapse main concerns are nerve root pressure due to foraminal narrowing and central cord compression. Nerve root pressure cause radiating arm pain and may be tingling numbness in the nerve distribution ( in your case C5 nerve). In case of cord pressure you tend to get myelopathy which can cause imbalance while walking, tingling in both hands, feeling of tightness in extremities and changes in urinary frequency and control on urination.
Coming to treatment option, we need to correlate the clinical findings with MRI findings. How severe is the pressure? Most important deciding factor is how much disability it has caused to you? if you are in pain and can not do your routine activities after adequate trial of medicine and physio for 4-6 weeks then you may need to consider surgical option.
About surgery, in your case you may need discectomy with fusion at the symptomatic level. In case of multilevel problems with cord pressure we may consider posterior laminectomy. These options depend upon the MRI findings.
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