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What Does This MRI Report For Neck Pain Indicate?
Question: I'm wanting to know what i should do for the following . my MRI reads as follow, at c6-c7 diminished disc signal with posterior broad based disc herniation measuring 2 mm in ap plane and appearing board based. There is no contact of the spinal cord. the formania are patent. i have had spinal injections, physical therapy, chrio and nothing is helping what do you all think i need to do now for the pain. Do you feel Surgery with a disc replacement will take my neck pain away. Should i be having this pain with this small of a herniation and no spinal cord problems
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from that MRI report I do not think that you should have surgery. The reported disc changes do not justify surgery, there is no compression of the spinal cord or of the nerve roots for the surgery to relieve. Also if by disc replacement you mean fusion remember that it causes mobility loss and puts other spinal levels at added stress predisposing for their damage in the future. If you mean artificial disc that eliminates that problem but still like every surgery has its risks and is not available everywhere.
You shouldn't be having this much pain with that MRI. Perhaps factors like muscle spasms play a role as well.
I would continue with physical therapy and medication for pain for now. I do not know what you have already tried. I suppose anti-inflammatory drugs like Ibuprofen have been tried. Perhaps muscle relaxants like Flexeril as well. Afterwards medication for neuropathic pain may be used, anticonvulsants like gabapentin, pregabalin or antidepressants like amitriptyline.
In some patients of mine cervical spinal traction has also revealed itself to be useful, it might be a remaining option.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern.
Judging from that MRI report I do not think that you should have surgery. The reported disc changes do not justify surgery, there is no compression of the spinal cord or of the nerve roots for the surgery to relieve. Also if by disc replacement you mean fusion remember that it causes mobility loss and puts other spinal levels at added stress predisposing for their damage in the future. If you mean artificial disc that eliminates that problem but still like every surgery has its risks and is not available everywhere.
You shouldn't be having this much pain with that MRI. Perhaps factors like muscle spasms play a role as well.
I would continue with physical therapy and medication for pain for now. I do not know what you have already tried. I suppose anti-inflammatory drugs like Ibuprofen have been tried. Perhaps muscle relaxants like Flexeril as well. Afterwards medication for neuropathic pain may be used, anticonvulsants like gabapentin, pregabalin or antidepressants like amitriptyline.
In some patients of mine cervical spinal traction has also revealed itself to be useful, it might be a remaining option.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have done muscle relaxers gabapentin all that. I have researched the mobi c replacement and I was thinking that was my relief. I'm 32 years old with an active family. I'm not looking for pain pills or anything. I'm looking for something to fix me. So Its my understanding a fusion Makes more problems down the road. I just want to get fixed now besides hurting for years and then doing surgery.
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information. I understand your difficulties especially at a young age having to look after your family.
Artificial discs like Mobi C do indeed hold more promise and should be better in the long run than fusion. However with that MRI report it is not something I would advise or my neurosurgeon colleagues would intervene really, you have no idea how many MRIs have some disc bulges and some diminished signal, but they are not intervened upon. So while you can always have the images seen by a neurosurgeon I wouldn't have high expectations.
If you haven't tried spinal traction I would give it a try. Of course doesn't guarantee success (nothing does in all spinal patients) and I do not prescribe it routinely in all my patients, but I have had a couple of difficult cases where it worked when nothing else had.
Read below.
Detailed Answer:
Thank you for the additional information. I understand your difficulties especially at a young age having to look after your family.
Artificial discs like Mobi C do indeed hold more promise and should be better in the long run than fusion. However with that MRI report it is not something I would advise or my neurosurgeon colleagues would intervene really, you have no idea how many MRIs have some disc bulges and some diminished signal, but they are not intervened upon. So while you can always have the images seen by a neurosurgeon I wouldn't have high expectations.
If you haven't tried spinal traction I would give it a try. Of course doesn't guarantee success (nothing does in all spinal patients) and I do not prescribe it routinely in all my patients, but I have had a couple of difficult cases where it worked when nothing else had.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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