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MRI showed to have Subluxation after fall. Have disc protrusion and osteophyte on thecal sac. Surgery needed?

Jul 2013
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Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Results of MRI state that I have Subluxation at c-5-c6 after a bad fall striking my kead. Small broad based disk protrusion and osteophyte impinging slightly on anterior thecal sac and cord. Moderate to prominent left facetopathy. My PC put me in a neck brace till I see a neurosurgeon or orthopedic surgeon. Will this require surgical intervention?
Posted Thu, 24 Oct 2013 in Brain and Spine
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer:
Conservative management is the initial choice.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

An initial conservative line of management is the option in your case.

Generally, the neck brace is to be worn for 2-3 weeks so as to allow the soft tissues to heal and return to their pre-injury status.

Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful.

If there is any persistence of INSTABILITY in the spine even after the rehabilitation period, which is confirmed by Flexion-Extension xray films or Dynamic MRI, then Surgical Fusion may be indicated.

Hope I have addressed your query. Happy to help further

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