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Suggest Treatment For Degenerative Disc Disease Of Cervical Spine

Posted on Tue, 25 Mar 2014

Question: ok thanks MRI Cervical spine without contrast. 8/27/13 History: Neck pain and bilateral arm pain No prior studies for comparison Degenerative changes are seen, including multilevel disk desiccation. There may be mild disk space narrowing, such as at C3-4, but no severe disk space narrowing is seen. Uncovertebral hypertrophy appears greates and likely moderate to severe or servere on the left side at C3-4. Posterior element hypertrophy is most pronounced and severe on the right at C4-5 with thin facet effusion. Marrow edema in the posterior elements adjacent to the right Cr-C5 fact joint is presumably on a reactive basis from the sever facet osteoarthropathy. No articular destruction to suggest septic joint, and no obvious paraspinal inflammatory changes. No significant central spinal stenosis. Neural forminal stenosis is severe on the right and moderate to severe on the left at C3-4 and sever on the right and moderate to severe on the left at C4-5. Cervical dis displacement is seen, greatest at C3-4 and C4-5. At C3-4 there is dis osteophyte complex, especially in the right greater than left paracentral to forminal regions, abutting the bilateral ventral nerve root. At C4-5, there is a smaller central bilateral paracentral to forminal disk ostephyte complex abutting the bilateral ventral nerve roots. I have already had 2 epidural cortisone treatments with no relief. I also most recently got a diagnosis of severe osteoporosis - and 3 years ago was on a high dose of steroids for lung sarcoidosis which has since improved. I have been taking ibuprofen and hydrocodone - used heat and ice on my neck. Wonder if surgery is my only option - although I have not made an appointment - got wrapped up in pain management - and this has not really helped. Should I be concerned that this could cause permanent problems? thanks!!

Answered by Dr. Indu Kumar (5 hours later)

Brief Answer: You should combine pain management & physiotherapy Detailed Answer: Hello XXXXX Thanks for writing to us According to history and reports you have degenerative disc disease of cervical spine. Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis which allows herniation of disc. According to MRI reports, 1.There is spondylotic changes in cervical spine and prolapsed disc osteophyte complex at C3-4 and C4-5 level is causing compression over exiting nerve roots in neural foramen (greater in right side) . Compression over nerve roots is the cause for your pain. Treatment for degenerative cervical disease includes physiotherapy or surgery. Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes. In acute cases,ideally physiotherapy should be started after pain subsides. Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc. Steroids are also used for foramen block and epidural injection,but it is not the definite treatment. Only pain management will give you temporary relief.You should combined it with physiotherapy. If it doesn't help then you can think about intervention. You should also modify your posture while sitting,standing and don't abruptly bend forward.Don't stand for prolong period.During standing position try to stand over one leg at a time so that entire body weight comes over one leg and other leg is in resting/folded position. You also need estimation of Thyroid profile. You should take calcium and vitamin D supplementation and don't take stress. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (1 hour later)

thank you - I found your answer very very helpful and your answer was easy for me to understand. Very much appreciated. thanks XXXXXXX

Answered by Dr. Indu Kumar (6 hours later)

Brief Answer: Thanks for your comments. Detailed Answer: Hello XXXXX Thanks for writing back Thanks for your comments. Get well soon. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar