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Dr. Andrew Rynne

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Exp 50 years

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Have neck pain. MRI showed moderate changes of cervical spondylosis. Any advice?

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Dr. S K Mishra

Spine Surgeon

Practicing since :1998

Answered : 116 Questions

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Posted on Thu, 13 Dec 2012 in Osteoporosis
Question: I am now suffering from neck pain, pain in left hand and tingling sensation in left hand upto fingers. In 2003 I had problem of disc prolapse in C5-C6 and a surgery for fusion of the gap was performed on 07/04/2003. Latest MRI done on 05th November, 2011. Impression is as under.
Moderate changes of Cervical spondylosis.
Bilateral paracentral bulge of C3-C4 disc indenting bilateral exiting nerve root(left>right)
Right paracentral heriniation of C4-C5 disc indenting right exiting nerve roots.
Posterior bulge of C4-C5 disc is noted in thecal case
Posterior osteophytes noted at C5-C6 level indenting thecal sac on left side.
Left paracentral protrusion of C6-C7 disc indenting thecal sac and left exiting root.
Please advise me whether conservative medicines are better or surgery is necessary.
doctor
Answered by Dr. S K Mishra 49 minutes later
Hi,
Thanks for sharing your concern with us.
You are really in a tough situation. As you have said there are only sensory symptoms and pain ( I suppose no muscle weakness) ,try conservative treatment first. However if there is muscle weakness or problem worsens with conservative treatment you may require surgery. Surgical options are
1. C456 corpectomy and fusion
2. By careful clinical examination and NCV, if it is found that only 1 or 2 of three discs (C34, C45, C67) are cause of your trouble and one disc bulge is not significant , you may again undergo discectomy at 1 or 2 significant levels, this time with artificial disc replacement.
3. Some surgeons may suggest a posterior laminoplasty .
Hope I answered your question. Let me know if you have any more concerns
Regards

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. S K Mishra 16 hours later
Sir,
How long I should try conservative treatment and opt for surgery.
doctor
Answered by Dr. S K Mishra 37 minutes later
Hi,
Thanks for writing back.
Conservative treatment can be continued for any length of time , if your problem does not increase and your routine life remains largely unaffected.
If the symptoms become worse or start disrupting your routine, surgery needs to be considered
Regards
Above answer was peer-reviewed by : Dr. Aparna Kohli
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