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Had an MRI for acute neck and arm pain. Posterior disc osteophyte complex effaces the ventral thecal space, radiculopathy noted, pinched nerve. What are the surgical options?

Hi- I recently had an MRI for acute neck and left arm pain. The results are as follows: C4-C5: Posterior disk osteophyte complex effaces the ventral thecal space but does not contact the ventral cord. there is a large uncovertebral osteophyte with only minimal/mild right uncovertebral osteophyte. The causes moderate to severe left neural foraminal narrrowing which may be causing radiculopathy . There is only mild right neural formaminal narrowing. This MRI goes from C2 to T1 and the C4-C5 is only an excerpt. My understanding is the foraminal space is narrowing pinching the nerve that runs down my left arm. Unfortunately, no medicine seems to help from Loritab to hydromophon. I m exploring surgical and other options (preferrably), in Utah and Colorado. Any help is greatly appreciated.
Asked On : Fri, 29 Mar 2013
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Neurologist 's  Response


Thanks for the query,

Before I respond to your questions, let me tell you that the management of disc problem whether medical or surgical depends upon the clinical and investigations findings. It should never be based upon the MRI findings. If a patient has pain and neurological deficit (documented by a neurologist) and pain has not responded to medical management and MRI shows problem with clinical correlation, then surgery is the best option. How ever, if a patient has pain alone and there are no other neurological deficits, initial treatment should always be conservative with medicines and physiotherapy. Persistent pain despite treatment is another indications for surgery. I still feel that if you do not have any weakness of hand, you may try medications like gbapentine, pregabaline nd physical therapy. If this fails you may consult a neurosurgeon to discuss about the various surgical options. The options are partial removal of the bones that causes the compression.

Hope this clarifies
Best wishes
Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy)
Consultant Neurologist and Epilepsy specialist
Narayana Hrudayalaya Hospital, Bangalore
My Blog in the Web site:
Answered: Fri, 29 Mar 2013
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