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What Does This Cervical Spine MRI Report Indicate?

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Posted on Fri, 2 Jan 2015
Question: MRI of cervical spine reveals spondylotic changes in the form of osteophytes, facetopathy and disc dessication at multiple levels. Mild disc bulge at C3/4 indenting the thecal sac with no significant neural compression. Posterior disc bulge is seen at C4/5 indenting the thecal sac with mild compression of bilateral exiting nerves. Posterior disc bulge with propensity to left seen at C5/6 indenting the thecal sac with mild compression of the bilateral exiting nerves more on the left.
Left foraminal disc protrusion with fissuring of the annulus is seen at C6/7 indenting the thecal sac with compression of bilateral exiting nerves more on the left.
Left foraminal disc bulge fissuring of the annulus is seen at C7/D1 indenting the thecal sac with compression of the left exiting neve.
Male 47 years. Doctors have presently advised conservative treatment - pain killers and physiotherapy. I am having constant pain in my neck and whole of left arm for nearly two weeks now. Kindly advise your diagnosis and how to get relief
doctor
Answered by Dr. Praveen Tayal (19 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for posting your query.
The description you have given above goes with Cervical Spondylosis.
You have features of Disc Prolapse at C5-C6-C7-D1 levels with moderately severe compromise of neural foramen.
Usually, the spinal cord and nerve roots are protected within the spinal canal. The spinal canal is guarded by the vertebrae which separated from one another by a cushion like intervertebral discs. With age, degenerative changes occur which leads to disc prolapse and spinal cord/nerve root compression.
Initial Treatment options include Pain Killers and Physiotherapy.
Treatment includes
1. Use of cervical collar helps in immobilisation and brings relief.
2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful.
3. Methylcobalamin supplements are also recommended for nerve compression symptoms.
4. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist.
5. Hot fomentation helps in relieving acute symptoms.
6. You can avoid using a pillow.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (5 minutes later)
Thanks for the prompt response Doctor.
I have been on cervical collar, painkillers, muscle relaxants as well as methylcobalamin for nearly two weeks now. The pain is constantly there and subsides only till the effect of the painkillers remain.

This is the third instance of my having similar problem (pain in the neck and the left arm and shoulder) in the last two years. Physiotherapy only helps to some extent. Can there be some long term solution.
doctor
Answered by Dr. Praveen Tayal (51 minutes later)
Brief Answer:
Surgery can be done.

Detailed Answer:
Hello.
Thanks for writing again.
The long term treatment is surgical decompression of the nerves that are causing the symptoms. After a pain relief you need to continue the physiotherapy exercises life long for a sustained relief.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (15 minutes later)
Thanks a lot. But I was also advised that will have to consider disc replacement surgery. Do you think that would be required in near term.
doctor
Answered by Dr. Praveen Tayal (1 hour later)
Brief Answer:
Any one surgery will be sufficient.

Detailed Answer:
Hello.
Disc replacement is not likely to be needed after the nerve decompression. It is better to go for discectomy or nerve decompression. Your neurosurgeon will be able to decide the best thing for you.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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What Does This Cervical Spine MRI Report Indicate?

Brief Answer: Details below. Detailed Answer: Hello, Thanks for posting your query. The description you have given above goes with Cervical Spondylosis. You have features of Disc Prolapse at C5-C6-C7-D1 levels with moderately severe compromise of neural foramen. Usually, the spinal cord and nerve roots are protected within the spinal canal. The spinal canal is guarded by the vertebrae which separated from one another by a cushion like intervertebral discs. With age, degenerative changes occur which leads to disc prolapse and spinal cord/nerve root compression. Initial Treatment options include Pain Killers and Physiotherapy. Treatment includes 1. Use of cervical collar helps in immobilisation and brings relief. 2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful. 3. Methylcobalamin supplements are also recommended for nerve compression symptoms. 4. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist. 5. Hot fomentation helps in relieving acute symptoms. 6. You can avoid using a pillow. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal