Herniated disc C5/C6

[Senia]

I recently had an MRI of my cervical spine, due to neck, shoulder, arm pain, headaches and numbness in hands.  The following is the report.

There is narrowing of the C5-6 interspace.  There are anterior and posterior marginal hypertrophic spurrings off the vertebral bodies at C5-6. There is hypertrophic spurrings of uncinate processes at C5-6 bilaterally, that result in bilateral neural foraminal stenoses at C5-6 (greater on the left than on the right).  There is shallow broad based posterior protrusion of the C5-6 disc.  Centrally, this results in slight indentation of the dural sac anteriorly at the C5-6 level.

Before I had the MRI, my insurance complany made me try PT first.  I went through the whole program, that was set up for me.  However, it did not help.  In fact, the cervical traction had to be discontinued, because every time I had it, I would develop a bad headache later in the day.  A couple of the exercises had to be discontinued also, due to increased pain.  I have an appointment with a neurosurgeon on Sept. 5.  I would like your opinion of the best next step to this problem, so I can compare it with what I am told on Sept. 5.

Thank you.

[MARCYEE]

I WENT THOUGH  CERVICAL  SURGERY OF THE NECK AND THEY PUT  HARDWARE IN MY NECK I AM NOW HAVING  HEAD  ACHES  SEVERE PAIN  NUMBNESS IN THE RIGHT  HAND AND LEG  AND TIGHTNESS IN THE NECK  WE BEEN THOUGH PT   PAIN MANAGEMENT
NEVRE BLOCKS  NEROLOGIST  ETC ... I AM  IN SEVERE PAIN THAT I CAN NOT FUNCTION WITH DAILY LIFE ....  THERE IS A THEROY THAT THE SCREW MAY BE ON A NERVE IS THAT POSSIBILE ???? I NEED HELP!!!!!!!  PLEASE LET ME KNOW IF THERE
IS ANYTHING I CAN DO

[Senia]

Well, I did see the neurosurgeon, on Sept. 5.  He wants to start with cervical spideral blocks,  to see if that controls the pain, rather than just jump into surgery.  I am for that, because my lumbar spine was a mess and within a 12 year period I had a lamanctomy and 2 spinal fusion.  The last fusion was in 2006, so I was happy to hear I didn't need immediate surgery.  Thanks for your answer.

[Stephen Ryu, MD]

You know it is very very hard to let you know what is going on based on an MRI report and some comments about your symptoms. I can only guess but you may have one of several different things wrong with your neck that may or may NOT need surgery.

I find MRI reports very hard to depend on because the variability of reports is so great. I really need to see films myself to be able to determine what is or is not a serious problem.

Having said that, your MIR suggests that you might have a surgical problem. It will depend on your history and exam to see if there is correlation.