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  • elesh
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    Post count: 13

    I have been suffering from neck pain for 2 years or more now. I had an MRI and Dr suggested I need surgery. I would like some advice and help if surgery is only option or i can have any other treatment. I am very scared of the surgery please help to clarify this result as it seems too complicated for me. Many thanks

    MRI CERVICAL SPINE

    TECHNIQUE
    Multi-planar,multi-sequence MRI of cervical spine was performed on 1.5 tesla phillips acheva scanner using 8 cahnnel nv coil

    OBSERVATION

    Curvature and Alignment
    Straightening and reversal of the normal cervical lordosis.
    Vertebral Bodies

    With anterior and posterior osteophytic formations especially at c5/6. Focal fatty deposits/hemangioma within the c5 vertebral body.

    Posterior elements

    Facetal arthropathy especially at c7/01 on theleft

    Discs

    Small right foraminal disc herniation at C3/4 right paramedian and foraminal disc herniation at c5/6 identing the discs and impinging upon the nerve roots at the recess and neuroforament left paramedian disc. Osteophyte complex at c6/7 also obliterating the theca and imping upon the nerve roots at recess and neuroforamen.

    Canal and Foramins
    Canal stenosis of about 8mm at c5/6, c6/7
    sorry posted in wrong sections before and dont know how to change. sorry for repost

    Paravertebral sof tissues normal.

    Spinal cord

    Slight cord impingement by the posterior disc osteophytic complexes at c5/6, c6/7. No obvious cord signal changes seen.

    Left paramedian disc osteophyte disc osteophyte complex at C6, the nerve roots at the recess and neurofaramen canal stenosis of about 8mm and slight cord impingement without myelopathy at c5/6, c6/7

    Thanks please advice if any further test can be done before I can decide if surgery is necessary and if surgery is only option in my case. Thanks

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    It is very hard to determine if you need surgery without understanding the symptoms you suffer from and your history/activity level. Are your symptoms myelopathy, radiculopathy or neck pain (see website for those descriptions)? With a narrowed canal but no significant exposure to dangerous neck activities (mountain/road cycling, surfing, skiing, horseback riding, contact sports) risks of cord injury are reduced.

    You do have a very narrowed spinal canal at C5-7; “Canal stenosis of about 8mm at c5/6, c6/7” but that is followed by the statement; “Slight cord impingement by the posterior disc osteophytic complexes at c5/6, c6/7. No obvious cord signal changes seen”.

    The statement; “Slight cord impingement” with a canal diameter of 8mm does not make sense to me as that should create at least moderate if not severe cord impingement. The radiologist is painting a picture that is hard to follow.

    Dr. Corenman

    elesh
    Participant
    Post count: 13

    Thank you for prompt reply dr
    Mainly neck pain.
    Never suffered any kind of injury previously

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Neck pain may be related to narrowing of the spinal canal as the degenerative changes that occur with degenerative disc or facet disease can cause neck pain as well as produce the bone spurs that compress the spinal canal. A neck pain workup is different than a suggested surgery for cord compression but these two potential surgeries may still be one and the same if these degenerative levels cause both cord compression and neck pain.

    If you are active (the noted sports I previously mentioned along with some others), you have a higher risk for cord injury (see central cord syndrome) due to head impact

    Neck pain can be worked up with a careful history and physical examination as well as evaluation of the images including flexion/extension X-ray images. Further studies such as discograms, facet blocks or SNRBs may need to be considered.

    Dr. Corernman

    elesh
    Participant
    Post count: 13

    Many thanks Dr really appreciate your help and feedback.

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