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Herniated disc with mild compression of right anterior hemicord, right auxiliary recess.Severe to warrant surgery?

I have a herniated disc and the MRI results say I have a large right posterolateral disc herniation with mild compression of right anterior hemicord and marked compression of right auxiliary recess on C4-5 (also mild disc space narrowing). Is this severe enough to warrant surgery pain in right shoulder and arm with finger numbness. Cannot lie down without severe pain.
Asked On : Wed, 20 Mar 2013
Answers:  2 Views:  237
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General & Family Physician 's  Response
Hi and thanks for the query,

There are specific conditions that have to be fulfilled to warrant surgery. If the pain does not respond to medical measures like drugs, injections of steroids into the affected regions , if the pain remains persistent after these measures and when signs and symptoms of nerve damage (paralysis, weakness, severe changes in sensitivity), its an indication to get surgery done.

You will need to concert and comply with recommendations of your orthopedic surgeon.

Thanks and kind regards,

Bain LE, MD.
Answered: Sat, 27 Jul 2013
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Orthopaedic Surgeon, Joint Replacement Dr. K. Naga Ravi Prasad's  Response
Jul 2013
Hi, thanks for writing to HCM.

The findings in your description suggests that you have CERVICAL DISC DISEASE with RADICULOPATHY.

The priliminary management of this problem would be conservative by the following means -

* 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: At a single epidural steroid injection will give very good results in relieving the radicular pain (shooting pain and numbness in the limb)

If all the above measures fail to provide you pain relief, then surgical decompression may be needed.

Consult an orthosurgeon and follow his advice.

Hope this information is helpful. Good day

Answered: Sat, 27 Jul 2013
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