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Hello Doc, History Neck Pain Since 4 -5 Months Severe

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Posted on Thu, 13 Feb 2020
Question: Hello Doc,

History
Neck pain since 4 -5 months
Severe neck pain prominent on the Right side radiating to the shoulder and arm since 2 months,
Twitching sensation in the hand and little numbness and weakness in right hand

MRI done
Diagnosis:
MRI Done , report says cervical spondylosis with degenration at multiple levels most prominent at c5/c6 and c6/c7 with neural impingement.
Treatment taken from 2 months

1. Myoril 8 mg

2. Tydol 50 mg

3. Gabapentin 300 mg

4. Prednisone 10 mg

5. pregabalin SR 75mg

No Improvement in neck pain at all, currently using hard collar to support the neck. Reports attached .

Kindly advice if this rquires surgery and if yes please explain in detail what kind of surgery and what are the chances of Success and what can go wrong.
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Follow up: Dr. Ajay Panwar (0 minute later)
Hello Doc,

History
Neck pain since 4 -5 months
Severe neck pain prominent on the Right side radiating to the shoulder and arm since 2 months,
Twitching sensation in the hand and little numbness and weakness in right hand

MRI done
Diagnosis:
MRI Done , report says cervical spondylosis with degenration at multiple levels most prominent at c5/c6 and c6/c7 with neural impingement.
Treatment taken from 2 months

1. Myoril 8 mg

2. Tydol 50 mg

3. Gabapentin 300 mg

4. Prednisone 10 mg

5. pregabalin SR 75mg

No Improvement in neck pain at all, currently using hard collar to support the neck. Reports attached .

Kindly advice if this rquires surgery and if yes please explain in detail what kind of surgery and what are the chances of Success and what can go wrong.
doctor
Answered by Dr. Ajay Panwar (7 hours later)
Brief Answer:
Can you send the CD of your MRI?

Detailed Answer:
Hi XXXXXXX
Thanks for being on Ask a doctor panel.
I'm Dr. Ajay Panwar, a neurologist, here to answer your query.

I have seen the images which you have posted. As you have developed weakness in right hand, that's not a good sign if it occurs due to nerve rot compression by disc, and becomes an indication for surgery; however, I'd like to see the whole MRI before making a comment. Can you send me the MRI CD as a mail? Please ask the support staff to help you in that.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ajay Panwar (0 minute later)
Brief Answer:
Can you send the CD of your MRI?

Detailed Answer:
Hi XXXXXXX
Thanks for being on Ask a doctor panel.
I'm Dr. Ajay Panwar, a neurologist, here to answer your query.

I have seen the images which you have posted. As you have developed weakness in right hand, that's not a good sign if it occurs due to nerve rot compression by disc, and becomes an indication for surgery; however, I'd like to see the whole MRI before making a comment. Can you send me the MRI CD as a mail? Please ask the support staff to help you in that.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ajay Panwar (2 hours later)
I have not got the CD doctor. Kindly advice basis the mri reports shared if we need to go for surgery and if yes what kind of surgery is done in such cases and for which disc in this case
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Follow up: Dr. Ajay Panwar (0 minute later)
I have not got the CD doctor. Kindly advice basis the mri reports shared if we need to go for surgery and if yes what kind of surgery is done in such cases and for which disc in this case
doctor
Answered by Dr. Ajay Panwar (8 hours later)
Brief Answer:
Possibly C6-C7

Detailed Answer:
Hi,
Thanks for being in follow-up.

As the symptoms are most prominent on right side along with hand weakness, you might possibly require C6-C7 disc surgery. But, that's just an assumption based on history and MRI report. The best opinion can be given after viewing the MRI in entirety and that's why I asked for a CD. Surgery usually involves either removing a lamina ( laminectomy) of the disc or removing out a part of disc ( discectomy).

Hope that helps. If you have any further queries, I shall be glad to answer them.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ajay Panwar (0 minute later)
Brief Answer:
Possibly C6-C7

Detailed Answer:
Hi,
Thanks for being in follow-up.

As the symptoms are most prominent on right side along with hand weakness, you might possibly require C6-C7 disc surgery. But, that's just an assumption based on history and MRI report. The best opinion can be given after viewing the MRI in entirety and that's why I asked for a CD. Surgery usually involves either removing a lamina ( laminectomy) of the disc or removing out a part of disc ( discectomy).

Hope that helps. If you have any further queries, I shall be glad to answer them.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ajay Panwar (5 hours later)
Hello Doc

The surgery is performed from back of the neck or from the front . Which has lesser risk and better success rate .

Also slowly now the pain has travelled to the left as well just below the neck..

Also want to understand what are the things which can go wrong in case the surgery is not successful.

Also, any blood tests you advice to do to rule out anythg associated ?
Kindly advice
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Follow up: Dr. Ajay Panwar (0 minute later)
Hello Doc

The surgery is performed from back of the neck or from the front . Which has lesser risk and better success rate .

Also slowly now the pain has travelled to the left as well just below the neck..

Also want to understand what are the things which can go wrong in case the surgery is not successful.

Also, any blood tests you advice to do to rule out anythg associated ?
Kindly advice
doctor
Answered by Dr. Ajay Panwar (7 hours later)
Brief Answer:
Usually from the back

Detailed Answer:
Hi,
Thanks for being in follow-up.

Mostly such a surgery will be done from the back side. I am a neurologist while a neurosurgeon will be the best person to explain you the success rates and complications of the surgery. Routine tests like blood counts, PT, INR, Blood sugar, viral markers, RFT may be required before surgery. Again, the neurosurgeon will tell you better about the protocol.

But firstly, I tell you to see a doctor in person with detailed MRI films for decision regarding the surgery. You can share the CD with me as well if you can get it somehow.

Hope that helps. If you have any further queries, I shall be glad to answer them.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ajay Panwar (0 minute later)
Brief Answer:
Usually from the back

Detailed Answer:
Hi,
Thanks for being in follow-up.

Mostly such a surgery will be done from the back side. I am a neurologist while a neurosurgeon will be the best person to explain you the success rates and complications of the surgery. Routine tests like blood counts, PT, INR, Blood sugar, viral markers, RFT may be required before surgery. Again, the neurosurgeon will tell you better about the protocol.

But firstly, I tell you to see a doctor in person with detailed MRI films for decision regarding the surgery. You can share the CD with me as well if you can get it somehow.

Hope that helps. If you have any further queries, I shall be glad to answer them.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ajay Panwar (3 days later)
Hello Doc

We got a new MRI done yesterday I want to seek your opinion basis the report. I am trying to see how I can share the CD also with you. But for now can you help me understanding the report what it says. As the pain has started in the left as well.

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Follow up: Dr. Ajay Panwar (0 minute later)
Hello Doc

We got a new MRI done yesterday I want to seek your opinion basis the report. I am trying to see how I can share the CD also with you. But for now can you help me understanding the report what it says. As the pain has started in the left as well.

doctor
Answered by Dr. Ajay Panwar (13 minutes later)
Brief Answer:
Problem is mainly at C6-C7 level.

Detailed Answer:
Hi,
Thanks for being in follow-up.

I've gone through the new MRI report which says that main disc problem is at C6-C7 level and that's also causing right side neural foraminal narrowing and abutting right sided nerve root. On left side, there is mild abnormality according to this report.

Hope that helps. If you have any further queries, I shall be glad to answer them.


Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ajay Panwar (0 minute later)
Brief Answer:
Problem is mainly at C6-C7 level.

Detailed Answer:
Hi,
Thanks for being in follow-up.

I've gone through the new MRI report which says that main disc problem is at C6-C7 level and that's also causing right side neural foraminal narrowing and abutting right sided nerve root. On left side, there is mild abnormality according to this report.

Hope that helps. If you have any further queries, I shall be glad to answer them.


Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ajay Panwar (3 hours later)
Should we go for surgery in such case or what is the alternative course of treatment
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Follow up: Dr. Ajay Panwar (0 minute later)
Should we go for surgery in such case or what is the alternative course of treatment
doctor
Answered by Dr. Ajay Panwar (16 hours later)
Brief Answer:
Please visit a neurosurgeon in person for expert opinion

Detailed Answer:
Hi,
Thanks for being in follow-up.

As you said that you have developed weakness in hand, that suggests that surgery might be indicated. But, without seeing the images fully, I don't want to make a conclusive remark. It's better that you see a neurosurgeon in person.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ajay Panwar (0 minute later)
Brief Answer:
Please visit a neurosurgeon in person for expert opinion

Detailed Answer:
Hi,
Thanks for being in follow-up.

As you said that you have developed weakness in hand, that suggests that surgery might be indicated. But, without seeing the images fully, I don't want to make a conclusive remark. It's better that you see a neurosurgeon in person.

Regards,
Dr.Ajay Panwar,
MD,DM(Neurology)
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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Hello Doc, History Neck Pain Since 4 -5 Months Severe

Hello Doc, History Neck pain since 4 -5 months Severe neck pain prominent on the Right side radiating to the shoulder and arm since 2 months, Twitching sensation in the hand and little numbness and weakness in right hand MRI done Diagnosis: MRI Done , report says cervical spondylosis with degenration at multiple levels most prominent at c5/c6 and c6/c7 with neural impingement. Treatment taken from 2 months 1. Myoril 8 mg 2. Tydol 50 mg 3. Gabapentin 300 mg 4. Prednisone 10 mg 5. pregabalin SR 75mg No Improvement in neck pain at all, currently using hard collar to support the neck. Reports attached . Kindly advice if this rquires surgery and if yes please explain in detail what kind of surgery and what are the chances of Success and what can go wrong.