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Have been having neck pain for long. MRI reported osteophyte. Suggestion?

Answered by
Dr.
Dr. Shivakumar S. Kupanur

Neurologist, Surgical

Practicing since :1997

Answered : 65 Questions

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Posted on Sat, 29 Dec 2012 in Brain Tumor
Question: Doctor,

History: I have been having neck pain for last 2 years with it getting more painful for last two months. I also have history of numbness/tingling in palms about year back and now it has increased and entire left arm becomes tingly and sometimes painful. I consulted Ortho doctor. I was put on rest for a week and some PT. Symptoms did not come down. Doctor advised for a MRI scan. MRI reported that I have osteophyte at C4 impinging the nerve root. Also I am diagnosed with early signs of degeneration.

Here is the MRI report: (I am 37 yrs old, male)

Findings:
1. Straightening of the cervical spine is noted - suggestive of
paraspinal muscular spasm.
Alignment is normal.
2. The vertebral bodies shoe normal outline and marrow signals.
Osteophytes are noted from vertebral body margins -
suggestive of early degenerative changes.
- Left postero-lateral osteophyte at C3-C4 level is causing
mild indentation of the
corresponding exiting nerve root.
- Small postero-lateral osteophytes at C4-C5 and C5-C6
level bilaterally without
causing significant nerve root comptression.
3. Appendages appear normal. Facet joints and flaval
ligaments are normal.
4. Cranio-verterbral junction is normal. Cervico-medullary
junction is normal.
5. Spinal cord is normal in size and signal intensity.
6. Pre and paravertebral soft issues are normal.
7. Dessication of all discs is seen
8. C3-C4, C4-C5 and C5-C6 discs show mild diffuse bulges
indenting dura without cord compression.
Rest of the intervertebral discs appear normal.

Impression:

1. Early degenerative changes
2. C3-C4 level left side postero-lateral osteophyte is indenting
the corresponding exiting nerve root.

Doctor's advise:
- Doctor just said I have a bad problem and it will take time for symptoms to reduce. He also said,
if my MRI is shown to a neuro surgeon, he would immediately advise surgery. He has prescribed 75 mg pregabalin (1-0-1) and neck exercises to strengthen neck muscles. He also mentioned that there
is a very high chance of this problem recurring again.

Questions:
1. What is my condition called (Disc degeneration disease, spondylolysis, osteoarthritis ..)?
2. How serious is the condition (especially since desiccation of all cervical discs is seen)?
3. What are my treatment options? Does chiropractic, ayurvedic or spinal cord decompression
treatments help?

Thanks a lot.
XXXXXXX
doctor
Answered by Dr. Shivakumar S. Kupanur 2 hours later
Hello.

Thanks for posting your query.

Degenerative disc disease is a disease complex with wide spectrum. This includes spondylitic changes and osteoarthritis. Meanings of all these terminologies almost overlap.

It is a very common disease now a days and many people are suffering due to this. This is not very serious. But, it needs to be treated on time to avoid complications.

Chiropractic, ayurvedic or any other massage therapies will not work. This is purely structural problem where a bony growth is impinging on nerve root to cause the pain in that distribution of nerve. So the root decompression will be the ideal treatment in failed conservative treatment like medications, rest and physiotherapy.

Medications like Retense can help to reduce the muscle spasm. You can consult your doctor for the same. Continue other medications like Pregabalin.

I hope, I have answered your query. I will be available for follow up queries if any.

Regards.




Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Shivakumar S. Kupanur 15 hours later
Thanks Doctor, for your clear replies. They are indeed helpful.

I have a follow-up question:

Is "root decompression treatment" a surgical procedure?
I am worried about the MRI observation that all cervical discs are desiccated. Are there any targeted exercises for this? I hear about non-surgical spine decompression treatment which claims to infuse fluid back into the dry discs. Is that an option?

Thanks again.
XXXXXXX
doctor
Answered by Dr. Shivakumar S. Kupanur 8 hours later
Hello again.

Yes, root compression is a surgical procedure wherein bone/osteophyte compressing the nerve root is excised.

Do not worry about your MRI findings. This is not a significant finding unless it is associated with root compression at all levels. Even many normal people can have this without any symptoms.

Targeted exercises can be done after consulting a physiotherapist. But, these exercises are not advisable during severe painful conditions. Once the pain settles with rest and medications, you can continue with exercises.

Non-surgical decompression is not an advisable procedure in your case. It is useful in very selected patients. Surgical treatment is ideal in this type of cases.

I hope, I have answered your query.

Wish you speedy recovery.

Regards.
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Shivakumar S. Kupanur 14 hours later
Thanks Doctor, that was helpful.

Regards,
XXXXXXX
doctor
Answered by Dr. Shivakumar S. Kupanur 16 minutes later
Hello.

I am happy that my answers could help you in some way. I will be available in future for any health concern.

Wish you good health. Take care.

Regards.
Above answer was peer-reviewed by : Dr. Shanthi.E
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