Cervical Cord Compression -- What To Expect

My neurologist has been treating me for years for ongoing lumbar spine issues (2 prior surgeries and was preparing to refer me to a surgeon for a 3rd til this neck issue arose).  He recently ordered a cervical MRI/MRA because I've been getting extremely dizzy and stumbling every time I look or reach up and have had some discomfort in my neck and across the top of my right shoulder.  It was one of those "just to be safe" things (wanted to be sure the vertebral arteries weren't being smooshed, and they weren't).

The MRI did show, however, that I have a large herniated disc and another large protruding disc, along with osteophytes, which are compressing the spinal cord at two levels ("severe" cord compression on one of the levels).  The neuro said I need to see a surgeon asap, and I am awaiting that appt.  In the meantime, I've tried to research the terms used and understand better what is wrong so that I'm well-informed when I see the surgeon.

I'm including the MRI results below.  If anyone would be kind enough to take a look and give me your thoughts (layperson or professional...anyone with input), I would appreciate it so much.  I want to be sure to have the best grasp on things I can so that I ask the right questions and get the right treatment.

In addition to the cervical spine MRI results, I've been having issues with my right leg for several months.  I've had some on and off sciatica, but the main thing that's bugged me is numbness and weakness in that leg, from the knee level down.  Every time I stand from either a sitting or lying down position, my lower leg goes completely numb and becomes very weak to the point I have to stop and wait it out before I can walk or I'll fall.  It lasts for a few mins and then clears up (although there's always some degree of numbness there).  It happens when I'm already up and moving sometimes, too, but especially when I first rise from lying or sitting down.

What I'm interested in knowing is whether we've maybe wrongly attributed the leg thing to my ongoing lumbar disc issues -- could the cervical spinal cord compression be causing it instead?  In the past, when I've had numbness in the other leg, it was always preceded and accompanied by really bad sciatica, and the numbness was along that path.  With the right leg, the sciatica isn't bad and is just occasional, but the numbness is there all the time and, although the sciatica overlaps it some, it's not entirely along the same path.  The numbness just seems way out of proportion to the sciatica based on my experience with the other leg.

There was just no way to make this brief, and I apologize.  From what the neurologist said, it's almost certain I'll have to have surgery.  How serious a problem is this -- does it really need immediate attention?  I'm wondering what type of surgery that would be, considering there are multiple issues going on with the cervical spine, and whether the numbness/weakness in the leg might possibly be related and might go away with the neck surgery (a silver lining that I'm hoping for!).  In the reading I've done online, it looks like I could possibly have something called cervical spondylitic myelopathy?

Things I didn't understand with the MRI:  What does a signal alteration mean?  I also have a protruded disc in the thoracic area effacing the cord.  Does that mean slightly touching it, but not enough to be a problem? (I hope!).  I looked up "congenital short pedicles" and understand what that is...is that something that would also require repair during surgery?

I'm a little anxious -- I am diabetic, have RA, chronic bronchitis -- and I'm not a spring chicken anymore (47 yrs old).  I count my blessings and am grateful I don't have something worse, but I have to admit that I am dreading this.  Thank you in advance to anyone willing to give input...I appreciate it more than I can say!

Here are the MRI/MRA reports:

Report #1 (MRI Cervical Spine):

PROCEDURE: PMR 0006- MRI CERVICAL SPINE W/O CONTRAST - Jan 4 2010
Accession #: 9890603

INTERPRETATION:
CLINICAL HISTORY: Stenosis

COMPARISON: None .

FINDINGS: The MR examination of cervical spine performed without IV
gadolinium. Additional sagittal T2 extension views were obtained.

There are multilevel cervical spondylosis with discogenic changes from C2
to C6. The spinal cord is compressed at C4-C5 and to a lesser degree
C5-C6 level. There is subtle and signal alteration within the cervical
cord just below the level of maximal stenosis at C5 level. There is no
mass lesion within the cord.

The extension view accentuated spinal stenosis at C4-C5 and C5-C6 level.

C2-C3: Negative for disc herniation. Facets are intact.

C3-C4: Shallow disc protrusion centrally causing moderate degree of
spinal canal narrowing in patient with congenital short pedicles.

C4-C5: There is a large right posterolateral disc herniation causing
severe cord compression. Moderate facet degeneration and uncovertebral
osteophytes present.

C5-C6: Broad-based right post lateral disc protrusion again noted
compressing the right ventral cord. There is moderately severe central
stenosis probably due to short pedicle.

C6-C7: Negative for disc herniation. Facets are intact.

C7-T1: Negative


CONCLUSION: Large right C4-C5 post lateral disc herniation compressing
the right ventral cord and causing severe stenosis. Broad-based right
C5-C6 disc protrusion also present causing moderately severe degree of
spinal canal stenosis.

Report #2 (MRI Thoracic Spine):

PROCEDURE: PMR 0016- MRI THORACIC SPINE W/O CONTRAST - Jan 4 2010
Accession #: 9890580

INTERPRETATION:
CLINICAL HISTORY: Stenosis.

FINDINGS: Normal thoracic spinal lamina bone marrow signal. The thoracic
cord is normal size and signal.

There is a broad-based left T3-T4 paracentral disc protrusion slightly
effacing the ventral cord.

Moderate facet degeneration at T9-T10, T10-T11 without significant
stenosis.

No paraspinal mass.

CONCLUSION: Left T3-T4 paracentral disc protrusion slightly effacing the
ventral cord.

Report #3 (MRA - Angiogram):

PROCEDURE: PMR 0109- MRI ANGIO NECK W/O CONT - Jan 4 2010
Accession #: 9890602

INTERPRETATION:
HISTORY: Neck pain. Dizziness.

PROCEDURE: 2 D and 3-D time-of-flight MRA sequences were obtained of the
extracranial cervicocerebral vessels. Source and MIP images are reviewed.
Measured stenosis of the extracranial ICA's reflects degree of stenosis
relative to distal normal ICA lumen diameter (NASCET Criteria).

CONTRAST: No contrast was administered per request.

FINDINGS:

The study is somewhat suboptimal secondary to significant susceptibility
artifact generated from dental metal/braces. It is especially prominent
at the skull base.


RIGHT CAROTID ARTERY: There is some focal plaque within the proximal
ICA. This appears to narrow lumen diameter by up to 60-70%.

LEFT CAROTID ARTERY: Normal with no evidence of plaque of significant
stenosis

The vertebral arteries are not well visualized at their origin or near
the skull base. However, cervical segments are widely patent.

PS...the neurologist said we might wanna get someone to look at the carotid artery thing but that the cord compression was the first concern.