Focal myelomalacia

I have muscular wasting into my right arm.  I have had two MRIs in the past two years.  The most recent suggest focal myelomalacia C6-C7 (as well as disc hermiation and mild to moderate canal stenosis at the same level.)  I have very little discomfort.  A recent EMG revealed chronic neurogenic changes in the right C6 and C7 myotomes with no evidence of active denervation in the right arm.

I'm concerned about the wasting, but hesitant about surgery.  My question is, does "no active denervation" mean the nerve damage is done?  Because I have so little discomfort, I'm not sure I want to do surgery if the muscle wasting will not reverse.

Thanks.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Indications for surgery in patients with herniated discs typically includes muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.

If you already have myelomalacia on MRI, then the damage is likely permanent in the area involved with the myelomalacia. However, you should discuss your surgical and nonsurgical options (such as physical and occupational rehabilitation) with a surgeon.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.