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Cervical lordosis, loss of normal disc with dehydration, weakness down the arm. Operation?

i have loss of cervical lordosis . multilevel loss of normal disc consistent with dehydration c4-c5 prminent osteodoscial bars which indent theca posteriorly no significant root compression c6-7 large central right paracentral disc protrusion causing compression on exiting c7 nerve . majot pain down arm and weakenss, tingling. will they operate?
Asked On : Mon, 18 Mar 2013
Answers:  3 Views:  92
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

Not each and every visible cervical disc protrusions on MRI needs surgical removal.

Loss of cervical lordosis indicates a protective muscle spasm which might have developed secondary to nerve root irritation.

Conservative management is always offered as first line treatment and is as follows -

* REST: A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.

* MEDICINES: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides.

* CERVICAL TRACTION: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

* PHYSIOTHERAPY: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful

* EPIDURAL STEROIDS: are useful for patients with severe radicular pains (tingling & numbness) in the limbs

If all the above measures fail to provide significant pain relief, then surgery may be indicated.

Hope this information is helpful . Good day
Answered: Wed, 31 Jul 2013
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Radiologist Dr. Indu Kumar's  Response
Apr 2014
Thanks for writing to HCM

You have degenerative disc disease in the form of disc prolapse and desiccation.It is causing nerve compression at C7 level.
Treatment is either physiotherapy or surgical.
Choice of treatment depends upon patients clinical assesment and MRI findings.
Now a days,endoscopic disectomy is done.
Radiofrequency ablation and ozone ablation can be done.

Take Care
Dr.Indu Bhushan
Answered: Wed, 31 Jul 2013
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Feb 2014
Thanks for writing to us.
The herniated discs compresses spinal nerves or spinal cord. Symptoms are experienced along the area of distribution/path of that particular nerve. This has happened at level of C6-C7 in your case.
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/ watching TV or working on computer.
Avoid prolonged sitting / leaning forward/ 2 wheeler driving for long distances.
A course of Muscle relaxants, interferential therapy (IFT) and/or Intermittent Cervical Traction (ICT) for a week followed by exercises will help you.
If there is no improvement with conservative measures, surgery is another option.
Hope this helps you.
Wishing you good health...
Dr Saurabh Gupta.
Answered: Wed, 31 Jul 2013
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