32 yr old female diagnosed with cervical spondylosis for 11

Patient

Q: 32 yr old female diagnosed with cervical spondylosis for 11 yrs now and tried different medications, physio, chiropractor and acupuncture with no help. My most recent MRI showed "The cervical spine shows loss of normal lordosis curvature with normal alignment of the vertebral bodies. C5,C6 shows posterior osteophytes.The vertebral bodies show normal height and marrow signal intensity. No evidence of fracture or dislocation seen. No evidence of destructive or sclerotic lesions present. The bony spinal canal appears normal at each level.
The intervertebral discs show normal height and reduced signal intensity.
C5-C6: broad based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT].
The cord shows normal signal intensity. CSF spaces are normal and show no evidence of mass lesion.
The atlas and axis are normal with no atlantoaxial subluxation.
The posterior elements and spinous processes are normal.
Facet joints and uncovertebral joints are normal.
No soft tissue prevertebral/ paravertebral collection is seen.


IMPRESSION:

Straightening of cervical spine due to muscle spasm
Cervical spondylosis deformans
C5-C6: broad based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT].

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
The very report,"Straightening of cervical spine due to muscle spasm Cervical spondylosis deformans C5-C6: broad based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT]." simply indicates that there has been a disc prolapse at C5-C6 vertebral levels and there has been compression of the nerve roots exiting from C5-C6 levels which is more on the left side compared to the right, thereby causing more pain and numbness over the left arm and forearm as compared to the right.
There has been a neural foramen narrowing which can cause compression of the cord if it worsens and can lead to paresis of all limbs in future. It is suggested that as traction is not helping you anymore, the likely answer to it is neurectomy and laminectomy to relieve the pain, along with removal od osteophytes which have over grown. This has to be followed by traction post surgery and use of pain killers for at least 1-2 weeks. Then after 3-4 weeks after re-evaluation, physiotherapy can be restarted to achieve mobility.
Please discuss the options with your Neurophysician and take an informed decision.
I hope i have answered your query in detail,
Wishing you good health,
Regards

Comments / Follow Ups

Patient: Thanks a lot doctor. Yeah, the problem is that I've had the numbness for long time with some mild weakness, but recently, weakness is becoming more and I even drop things sometimes which made me repeat the MRI after years
Doctor: Hello,
This requires a surgery now and preventive, supportive and holistic medicine cannot treat the cause as of now. So get yourself reviewed soon please,
Regards
Patient: Hello again dr.

I am scheduled to meet a neurosurgeon in 4 days, but there was a new development which concerned me. For the past 10 days, my Left thumb and to a lesser extent my Left 2nd finger started twitching, it was not that much in the beginning, but for the past 5 days it happens almost continuously and the Right hand started to be affected too. Does that mean my problem is getting worse? Thank you
Doctor: Hello,
Well if there has been twitching of the 2nd finger and numbness of the thumb then it is likely that the condition is worsening here unless there is a local cause of median nerve compression alone, but as the symptoms are bilateral, the likely cause remains at the spinal vertebral level. It is right on your part to have scheduled your appointment with a neurosurgeon. Please get back with evaluation reports.
Regards

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