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Suggest treatment for mild diffuse bulging disc - Online Doctor Chats

Date : 10-Apr-2014
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1558 Questions
User:I just received an MRI report of my cervical spine. I have had heacdache and back pain and am fused from C4 -C7. The MRI states that there is a mild diffusely bulging disc at this interspace producing mild anterior thecal sac impingement. XXXXXXX to metallic artifact from the pedicle screw placement, this examination is quite limited. Nothing obvious is seen however. How serious is this? Would it require surgery? I have had 2 posterior and one anterior fusions already.
Doctor:Hello
User:Hello Dr. XXXXXXX
Doctor:Hello
Doctor:Mild diffuse bulging does not require a surgical intervention
Doctor:you can wait and see if it improves with conservative management
User:Can the disc be corrected by cervical PT exercises?
Doctor:as you might be knowing, since this is a degenerative process, it is hard to limit the progression
Doctor:With cervical PT, the progression can be slowed down
Doctor:We can not reverse what has already happened
User:What about the use of steroids to control the inflammation?
Doctor:We can slow down the process of degeneration with Physical therapy
Doctor:Yes, steroids help greatly in reducing the inflammation of the nerves
Doctor:that is a part of conservative therapy
User:The pain is now going down my arm and into my fingers as well as my back. I suffer from acute migraines as well.
Doctor:it will allow you to continue the PT without much trouble, there by help reduce the rate of progression as well
Doctor:Yes, that sounds like the pain is due to the disk bulge
Doctor:hopefully it may be relieved by steroid injections and PT
Doctor:in due course of time you may require a surgical intervention to remove the bulging disc
Doctor:but it is not the preferred treatment option right now
User:I was due to have a triple arthrodesis of my foot, but the surgery was canceled, because the surgeon stated that I could break my neck on the operating table or during non-weight bearing recovery. Is this true?
Doctor:Yes
Doctor:considering the kind of degeneration you have had
Doctor:it is best to avoid triple arthrodesis
Doctor:That surgery involves considerable amounts of force applied while performing the surgery in directions that might make yuor neck bend
Doctor:hence your doctor's decision not to go ahead
User:I had a triple arthrodesis in 2010, fell during recuperation, and broke the metal in my foot. The metal was removed, but my foot is now deformed and I have been casted for a brace.
Doctor:Oh, okay
Doctor:that makes things even worse
Doctor:When you have had spinal fusion surgeries, every other surgery is a major risk
Doctor:It is the surgeon's discretion to go ahead with the surgery or not
User:Yes, my activity level is extremely limited and my quality of life is poor.
Doctor:I can understand your condition
User:I don't believe that a neurosurgeon will operate on a C3 - C4 level and above. Am I correct?
Doctor:Yes
Doctor:It is too risky to operate above the C3 -C4 level
User:So I have no other options other than PT and steroids?
Doctor:any jerk can fracture the C1
Doctor:I am afraid no, you don't have any option
User:So I must live with the neck and foot pain without hope for improvement?
Doctor:We are still an evolving species
User:Ok. Thank you for your response. Good day.
Doctor:we were walking on 4 limbs in Africa a few million years ago, that is short time to undergo a major change
Doctor:Our backs are not well suited enough to carry so much weight
Doctor:As I said, it is not possible to limit this progression
Doctor:I hope you will get enough pain relief from conservative management
Doctor:Thank you for consulting me here
Doctor:Take care
Doctor:bye
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