Hi Dr. Keerthi, I m a 59 year old woman. The MRI of my cervical spine shows degenerative disk disease at C3-4, C4-5, C5-6, and C6-7 as well as a loss of disk height at those levels. There are disk bulges at C3-4, C4-5, and C5-6 which result in mild central stenosis at C3-4 and C4-5 and mild to moderate central stenosis at C5-6. There is also mild right foraminal stenosis at C3-4, mild to moderate right foraminal stenosis at C4-5, and moderate left foraminal stenosis at C4-5. At C5-6, there is severe left foraminal stenosis. I have no pain at all, but I do have pins and needles and left upper arm weakness. My neurologist did not believe my condition was severe enough to require surgery, but referred me to a surgeon for his opinion. His recommendation is that I should have a C4 through C6 ACDF. What is your opinion based on my MRI report? FYI - the report on my nerve conduction test was: neurodiagnostic evaluation is remarkable for chronic neurogenic changes in left C5-C6 nerve route distribution. Patient shows significant clinical weakness of left deltoid muscle with occasional muscle fasciculation. Differential diagnosis includes C5-C6 cervical disc disease, left sided brachial plexopathy. I would very much appreciate your thoughts. Thank you, Joy