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How To Determine The Severity Of Degenerative Spine Disease?
Question: Hi
I am suffering from cervical spondilytis and c3, c5 discs bulging out .
Doctor has advised my surgery immediately stating that in case of jerk it may cause serious damage to spinal cord.
Pl advise. Also I am having sever pain in my left shoulder and upper arm and taking Mobzox with Pan40 twice a day to do my regular work.
Kindly suggest .
Regards XXXXXXX
I am suffering from cervical spondilytis and c3, c5 discs bulging out .
Doctor has advised my surgery immediately stating that in case of jerk it may cause serious damage to spinal cord.
Pl advise. Also I am having sever pain in my left shoulder and upper arm and taking Mobzox with Pan40 twice a day to do my regular work.
Kindly suggest .
Regards XXXXXXX
Brief Answer:
Please upload your MRI CD or image.
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
As a protocol approach,surgery in disk disease or degenerative spine disease is only required if the patient's symptoms are not responding to medicines and physiotherapy.
I have gone through your MRI report which says a large posterocentral herniation at C4-C5 with spinal cord compression and radicular compression.Surgery may be the choice depending on the severity of the compression.
I would suggest you to either upload the MRI image or preferably upload the MRI CD on google drive and share the link here in the follow up question,so that I can view your MRI with my default dicom viewer.
I shall be looking forward to your follow up question with MRI CD/image.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please upload your MRI CD or image.
Detailed Answer:
Hi XXXXXXX
Thanks for being on healthcaremagic.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
As a protocol approach,surgery in disk disease or degenerative spine disease is only required if the patient's symptoms are not responding to medicines and physiotherapy.
I have gone through your MRI report which says a large posterocentral herniation at C4-C5 with spinal cord compression and radicular compression.Surgery may be the choice depending on the severity of the compression.
I would suggest you to either upload the MRI image or preferably upload the MRI CD on google drive and share the link here in the follow up question,so that I can view your MRI with my default dicom viewer.
I shall be looking forward to your follow up question with MRI CD/image.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Please check if you can access it from
https://drive.google.com/drive/folders/0BzRu7MMkROoNYS1CXzRvV09lWTA
Pl use below link if above doesn't work.
https://drive.google.com/folderview?id=0BzRu7MMkROoNYS1CXzRvV09lWTA&usp=sharing
https://drive.google.com/drive/folders/0BzRu7MMkROoNYS1CXzRvV09lWTA
Pl use below link if above doesn't work.
https://drive.google.com/folderview?id=0BzRu7MMkROoNYS1CXzRvV09lWTA&usp=sharing
Brief Answer:
Please tell some details
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and uploading MRI images.
I have gone through the images thoroughly.
Of course, there is a significant disk herniation at C4-C5 level and it is causing severe left neural foraminal narrowing. However, whether to go for surgery in this case depends upon the symptoms and response to medicines and conservative management, including physiotherapy exercises. Going directly for surgery is not the recommended approach.
I would like to know some details in order to answer it further-
1)Did you have a sudden jerk or fall or trauma,which might have precipitated this herniation?
2)Since how many days are you having pain?
3)Is the pain improving with medicines?
Please follow up with details so that I can answer this well.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please tell some details
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and uploading MRI images.
I have gone through the images thoroughly.
Of course, there is a significant disk herniation at C4-C5 level and it is causing severe left neural foraminal narrowing. However, whether to go for surgery in this case depends upon the symptoms and response to medicines and conservative management, including physiotherapy exercises. Going directly for surgery is not the recommended approach.
I would like to know some details in order to answer it further-
1)Did you have a sudden jerk or fall or trauma,which might have precipitated this herniation?
2)Since how many days are you having pain?
3)Is the pain improving with medicines?
Please follow up with details so that I can answer this well.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
1 No jerk or sudden did I experience
2 I first experienced the pain on 23 October since then I can do my daily work without painkiller mobizox
3 I also took TENS from physiotherapist for 5-6 days ,it was ok but no relief without painkiller
My main concern is how long I can live on painkillers , what is solution for me ,also I m taking nerve strengthening medicines as prescribed.
Mobizox is must for me twice a day one tablet ,also what about c3 pl see the images it's also having issues
2 I first experienced the pain on 23 October since then I can do my daily work without painkiller mobizox
3 I also took TENS from physiotherapist for 5-6 days ,it was ok but no relief without painkiller
My main concern is how long I can live on painkillers , what is solution for me ,also I m taking nerve strengthening medicines as prescribed.
Mobizox is must for me twice a day one tablet ,also what about c3 pl see the images it's also having issues
Brief Answer:
Antineuralgic medicines/Physiotherapy
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and telling further details.
Medicines and dedicated spinal exercises should improve the symptoms within 4-6 weeks.Your doctor can put you antineuralgic medicines like amitriptyline,pregabalin or duloxetine. Along with, non steroidal anti-inflammatory medicines may be given.These drugs are likely to improve the symptoms when coupled with regular physiotherapy exercises.Painkiler like Mobizox can be stopped once the symptoms improve.Epidural steroid injections may also be considered if oral medicines do not improve the symptoms much.
If more than 6 weeks of medicines and physiotherapy does not improve the symptoms,then surgery may be considered.
C3-C4 disc bulge is not significant and is not causing much neural foraminal compromise or canal stenosis.
If you have further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Antineuralgic medicines/Physiotherapy
Detailed Answer:
Hi XXXXXXX
Thanks for being in follow-up and telling further details.
Medicines and dedicated spinal exercises should improve the symptoms within 4-6 weeks.Your doctor can put you antineuralgic medicines like amitriptyline,pregabalin or duloxetine. Along with, non steroidal anti-inflammatory medicines may be given.These drugs are likely to improve the symptoms when coupled with regular physiotherapy exercises.Painkiler like Mobizox can be stopped once the symptoms improve.Epidural steroid injections may also be considered if oral medicines do not improve the symptoms much.
If more than 6 weeks of medicines and physiotherapy does not improve the symptoms,then surgery may be considered.
C3-C4 disc bulge is not significant and is not causing much neural foraminal compromise or canal stenosis.
If you have further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. Panwar for the answers.
1- I am taking Gabapin as prescribed by my doctor here, is it ok, also I was in very bad condition inittially but since I started taking mobizox, I can do my daily work. should I consider it as I am responding well to medicine or its painkiller effect.
2. In my case do you think physiotherapy would be effective to send the bulging disc back to its normal position, if yes, what action is recommended for me ?
My doctor told me that in case of heavy jerk you may collapse due to pressure on spinal cord, is it true ?
Thanks and regards XXXXXXX XXXXXXX
1- I am taking Gabapin as prescribed by my doctor here, is it ok, also I was in very bad condition inittially but since I started taking mobizox, I can do my daily work. should I consider it as I am responding well to medicine or its painkiller effect.
2. In my case do you think physiotherapy would be effective to send the bulging disc back to its normal position, if yes, what action is recommended for me ?
My doctor told me that in case of heavy jerk you may collapse due to pressure on spinal cord, is it true ?
Thanks and regards XXXXXXX XXXXXXX
Brief Answer:
Continue medicines and physiotherapy.
Detailed Answer:
Hi,
Thanks for being in follow-up.
Answers to your queries are:
1)Gabapin is a good option as an antineuralgic medicine.You should continue it along with calcium,vitamin D and methylcobalamin supplementation.For now,you should
continue medicines and physiotherapy and observe for another 2-3 weeks.If you are on improvement,gradually you will feel normal even without painkillers.
2)Physiotherapy will help to strengthen ligaments and muscles associated with spine.It will thus prevent future disc bulge and help to reduce the current disc bulge.
3)In case of heavy jerk associated collapse,it is not like,that your spinal cord will get damaged in minutes.If such a thing happens,emergency spinal surgery can be done to
salvage the spinal cord functions.But,doing a preventive surgery is not recommended due to that fear.Further,even after surgery,a patient has fair chance of getting disc
bulge again in future.So,surgery should be done when absolutely indicated.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Please get back to me in case you have any query in future.
You can also put up a query directly to me on HCM address- http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69273
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Continue medicines and physiotherapy.
Detailed Answer:
Hi,
Thanks for being in follow-up.
Answers to your queries are:
1)Gabapin is a good option as an antineuralgic medicine.You should continue it along with calcium,vitamin D and methylcobalamin supplementation.For now,you should
continue medicines and physiotherapy and observe for another 2-3 weeks.If you are on improvement,gradually you will feel normal even without painkillers.
2)Physiotherapy will help to strengthen ligaments and muscles associated with spine.It will thus prevent future disc bulge and help to reduce the current disc bulge.
3)In case of heavy jerk associated collapse,it is not like,that your spinal cord will get damaged in minutes.If such a thing happens,emergency spinal surgery can be done to
salvage the spinal cord functions.But,doing a preventive surgery is not recommended due to that fear.Further,even after surgery,a patient has fair chance of getting disc
bulge again in future.So,surgery should be done when absolutely indicated.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Please get back to me in case you have any query in future.
You can also put up a query directly to me on HCM address- http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69273
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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