Hi,
I have neck pain and spasms, pain that radiates from neck down right arm pain, upper left back numbness, and a tremor in my left hand. The doctor ordered a cervical mri. After getting the results she referred me to a neurosurgeon. I am looking for opinions on MRI results below. Do you think surgury will be necessary?

Thanks,
Melissa T.

HISTORY: Neck pain for several weeks, shooting pains down right arm.

PROCEDURE: Multiplanar, multisequence images of the cervical spine was done.

FINDINGS: There is straightening of the normal cervical lordosis. Anterior
spondylosis is seen at C4-C5, C5-C6. This is confirmed on the plain films of
11/23/2011 showing anterior spondylosis at C5-C6. Disk space height loss is
seen at this level with degenerative disk.

On transaxial images C2-C3, C3-C4 there is no neurocanal or neuroforaminal
stenosis or focal disk protrusion.

C4-C5: Diffuse circumferential bulge is seen that is asymmetric to the right
with right paracentral disk protrusion. This abuts the cord, but does not
flatten it. The neuroforamina is patent.

C5-C6: Disk osteophyte is seen with asymmetry to the right that effaces and
flattens the cord. This extends partially into both neuroforamina right greater
than left.

C6-C7: Small right paracentral disk protrusion is seen without an abutment of
the cord. The neuroforamina is patent.

C7-T1: There is no neurocanal or neuroforaminal stenosis or focal disk
protrusion.

IMPRESSION:
1.) Degenerative disk seen at C5-C6 with anterior spondylosis. Diffuse disk
osteophyte is seen with asymmetry to the right with flattening of the cord.
2.) At C4-C5 there is a right paracentral disk protrusion seen that abuts the
cord.
3.) Straightening of the normal cervical lordosis seen with small right
paracentral disk protrusion at C6-C7.

JOB: 166802[/I]

I'm no doctor so this is ONLY my opinion, but you MIGHT be able to get away with putting off surgery for awhile, but since the discs are flattening the cord, it won't be long before you will HAVE to have the surgery --- so you might as well have it now before it becomes an emergency situation! You certainly don't want any permanent nerve damage either!

I'm glad you're seeing a Neurosurgeon, but please get at LEAST one other opinion besides this one. Two would be best! You never want to jump into surgery without exhausting all other options!

I wish you the very best. Take care & God bless. Hugs, Lee

Hi Melissa,

I am a doctor and would tell you to stop asking people here whether or not you need surgery based off of what untrained individuals tell you from reading your MRI report. An MRI is a visual snapshot of one moment in time that MUST be correlated with your compaints and physical exam findings. It is supportive only, of your diagnosis. Your findings are comparatively not that bad. And BTW, you have other conservative measures to try; medrol, epidurals, PT, accupuncture, chiropractic, time.....

Most of all, be patient....go see the neuro but please be aware that controlled studies have shown that those having discectomy/fusion do no better than those who do not have surgery at 1 year post (subtracting those who were surgically emergant, of course). You might need surgery; who knows? But no one can make that call by only reading an MRI reprt. Time and statistics are on your (non-surgical) side.

I agree with Dubious. You meed to get the opinion of professionals who will read the MRI reports an discuss your physical symptoms. People may have the same reports from an MRI but have very different physical symptoms. You and your doctors are the only ones to make such a serious decision.