cervical surgery or not - 2 completely different opinions

c6-c7:  moderate loss of disc height; central and right paracentral disc osteophyte with moderate thecal sac indentation and moderate central stenosis (7-8mm); mild right lateral spinal cord compression; moderate bilateral c7 uncinate hypertrophy with degenerative bilateral c7 neural foraminal stenosis.

MRI conclusion:  c6-c7 greater than c5-c6 central stenosis with right greater than left c7 root sleeve impingement; clinical correlation myelopathy and/or c7 radiculopathy.

1st neurosurgeon said surgery immediately to prevent further damage although questions why symptoms (onlyy sympton: tingling in hand and fingers) presenting on the left (No Pain). BTW - emg negative after 1 month of symptoms.

2nd orthopaedic spine surgeon looked at MRI and said no way 7-8mm stenosis - wouldn't have let you leave without surgery. Said films did not agree with 7-8mm numbers and/or symptoms.  Suggested waiting another month.

Questions:
1) Is physical therapy an option?
2) Is there a risk of doing nothing?
3) Who best for third opinion - spine surgeon or neurosurgeon? (in Boston area/)

[kittyluv1]

The results of your MRI do show significant stenosis and impingement of the nerve root and spinal cord (thecal sac).  I am surprised you are not having many symptoms as I would imagine tingling/numbness of arm/hand and neck/shoulder pain.  The difficulty of deciding re: surgery is whether to take the chance of potential permanent damage or alleviating the source by removing the offending disc material (osteophyte).  The longer the nerve remains compromised the greater the chance of permanent damage.  While your symptoms at present may not be too severe, the potential for further damage does exist. Stenosis is not repaired by physical therapy.  Doing nothing can result in further problems including difficulty with walking, loss of bowel and bladder control, etc. These symptoms may not occur for awhile, but should you have an accident or further trauma, they could arise overnight.
I am having anterior cervical discectomy and fusion for very similar problems.  My neurosurgeon stated that interpretation of the MRI can be very subjective and that a neurosurgeon familiar with this degeneration process is probably more inclined to be correct in the interpretation of the films.  My neuro apparently does approximately 250 neck surgeries a year.  (Nice to know so many people are so afflicted -- not a group I am happy to join!)
I would probably seek a neurosurgeon who has performed this type of surgery at least 200 times for a third opinion should you chose to pursue it.
Surgery can be very scary and a decision to proceed has to be based on current symptoms, potential damage and quality of life issues.  I wish you the best and hope that whatever you decide to do the results are successful.