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MRI showed flattening of the cord with mild spinal stenosis. What treatment should be done?

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Neurologist, Surgical
Practicing since : 1997
Answered : 96 Questions
I just got this diagnosis can you explain what if anything should be done?
1. Significant C5-6 and C6-7 degenerative disc disease. At C5 -6, is with mild uncovertebral joint
disease. A small broad based protrusion is present. Flattening of the cord, with mild spinal stenosis is
seen. At C6 - 7a small left eccentric disc protrusion is seen., superimposed on uncovertebral joint
disease. Mild central canal and mild left neural foraminal stenosis.
2. No evidence for cord edema. Mild cerebellar tosillar ectopia, without evidence for a Chiari
Posted Thu, 14 Mar 2013 in Brain Tumor
Answered by Dr. Visvanathan K 1 hour later

Let me try and explain your MRI findings. There is evidence of wear and tear in your neck at two levels. 1. The disc material at the C5/6 level has bulged and is touching the spinal cord.
2. At the level below it, the bulge is more to the left side and there is a compression where the nerve exits from the spinal cord at that segment.

As to your question whether something needs to be done: All depends on the kind of symptoms that prompted your doctor to order a scan in the first place and what he found in you when examining you. I can hazard a guess that maybe you have brachialgia on the left side. If in addition to this pain, you have clinical evidence of spinal cord compression (myelopathy in medical jargon), then surgery is the treatment.
If you only have brachialgia, then the options are painkillers and wait and watch for a while. Most patient's symptoms subside after a while following which beginning a program of neck strengthening exercises can help. If symptoms don't subside then an operation on the neck is an option.

Some centers have a pain clinic where there may be a pain specialist who can inject painkillers or steroids directly onto the nerve root.

Hope this answer helps. If you have any more queries, please do let me know. Or else, please close this query and give your ratings.

Above answer was peer-reviewed by
Follow-up: MRI showed flattening of the cord with mild spinal stenosis. What treatment should be done? 43 minutes later
This stemmed from an accident that happened two years ago, until now I haven't had the money to pay for the MRI. Since the accident I have numbness and tingling in my hands every night, headaches on and off, weakness and pain in the left arm and last some muscle spasm on the left side ventrally and dorsally. Given that it sounds like surgery according to your answer is the recommended treatment. this will be my second neck surgery and it scares the beans outta me, are there any other options?

the last two surgeries I had took around a year to recover from.

Answered by Dr. Visvanathan K 20 minutes later

Because of the arm tingling, numbness and weakness that you report it certainly seems likely you have nerve root compression, predominantly on the left side. Surgery isnt the only option. If routine pain killers are not helpful, you can consider getting a referral to a pain specialist who deals with cervical nerve root injections. This can certainly take the edge off the pain. However, some centres do not offer it as an option. there is nothing on the report to suggest you've had a pervious neck operation. Therefore, I presume you have no metal work inserted into your cervical spine.

Of all your symptoms, the headaches are unlikely to improve even after surgery. It may not be related to the neck problems or it may be what is called "spondylotic headaches" if it is restricted to the back portion of the head. The tingling and pain in the arms usually improve. Neck pain, numbness in the arms and the weakness may or may not improve. Therefore, before opting for the surgery you need to be clear in your mind about what your expectations are after the surgery and make the decision after careful thought.

As far as the "tonsils" go- all of us have a part of the hind brain called the cerebellar tonsils. These can poke a little bit down through the spinal canal and this is usually within the normal range. Only when there is a much larger herniation is the condition called Chiari malformation and something needs to be done about it.

Hope I have clarified your doubts. I will be pleased to comment further if needed.

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