Severe Cervical Spine Issues...need advice

MRI obtained following results.  Will be going to two neurosurgical consults and need some good questions to ask while there, your suggestions/advice, etc.  Results are as follows:
1) Severe central canal stenosis at C4-5 & C5-6  due to presence of posterior disc/osteophyte complex. C4-5, posterior disc/osteophyte complex measuring up to 5mm AP mildly indents anterior spinal cord.  Lesser degree of ant. spin. cord indent. is present at C4-5.  Min. CSF maintained at posterior to cord at both levels.
2) Syringohydromyelia Measuring 3mm Di x 5 mm long present at C5.  Two smaller syr. present at T3 and upper T4
3) Severe left neuroforaminal narrowing present at C3-4 & C5-6.  Moderate left neurofor. narrowing at C4-5 & C6-7.  Moderate right neurofar. narrowing at C4-5
4) Severe Spondylosis of lower cervical spine with degenerative disc disease at C4-5, C6-7 and reversal of normal cervical lordosis is present.

Any suggestions, surgical, medications, rehab., etc....questions to ask at consults, how to proceed, etc., specialists known for this surgery, etc....greatly appreciated.

[Stephen Ryu, MD]

It is very very hard to make any suggestions based on an MRI report. Actually, given the findings on the MRI that seem significant, without a history and physical exam, it is impossible to recommend the appropriate treatment.

Your scan implies you have severe cervical stenosis and spondylosis - that is degeneration of the spine and narrowing of the spinal canal. The syringomyelia implies that there might be early cord injury. You might be in imminent need of surgery, or not. It is very hard to know based on a report.

If you have signs of myelopathy (numb hands, difficulty walking, jerkiness, weakness) then you will probably need surgery. If you need surgery, I do not know if you need a front operation, a back operation, or both front and back surgery without looking at the films.

I think you are doing the right thing to get multiple opinions, so long as you are not deteriorating rapidly. If you have increasing pain, weakness, bowel/bladder issues, you need to go to the ER.

Otherwise, listen to the surgeons and see if they are explaining things clearly and making sense to you. I typically recommend surgeons who can articulate what is going on so that you can understand what is going on and how to fix it.  

Do NOT get physical therapy or manipulation before getting a medical opinion - based on this report.

Good luck!