MRI of cervical spine--interpretation?

Neurologist has referred me to a neurosurgeon--not sure if my MRI results warrant surgery. I've had a fusion at C-6-7 10 years ago. Here's what the MRI says:

Impression
1. There is multilevel degenerative disc disease throughout the cervical spine post anterior fusion at C-6-7 with satisfactory imaging appearance to the operative level.
2. At the level just above the surgical level at C-5-6, there is disc bulging or protrusion and spondylosis as well as posterior element hypertrophy and evidence of mild cord compression and probable significant stenosis of both neural foramina.
3. There is disc bulging and spondylosis through the remainder of the upper cervical spine; however, there are no significant disc protrusions, cord compression, or foraminal stenosis.
4. At T-2-3 there is evidence of some mild cord compression ventrally due to degenerative changes. This is seen only on the sagittal plane as axial images were not acquired this far inferiorly.
5. There is evidence of previous anterior fusion and placement of anterior internal fixation plate and screws.
6. There is a reversed cervical lordosis extending from C-2 through C-5-6 and there are mild anterior listheses of C-2 on C3, C3 on C4 and probable mild retrolistheses of C4 on C5 and C5 on C6.

Not sure if I will need another surgery. Any comments?

[Dr. A. Srivastava]

Thank you for your question. Although without being able to placing your findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice that you need surgery or not. However, I will try to provide you some relevant information about your health concern.

Your reports suggest that there is cervical disc herniation at different levels. It will be best that you consult a neurologist who would like to prescribe Pain killers, steroid and muscle relaxants. Other treatments could be cervical orthosis such as a soft cervical collar or stiffer neck brace to restrict neck movement. In addition, cervical traction may also be suggested by the doctor, if condition is severe. Hope this helps.

[kay290]

C5-6 has been stressed due to the new disc putting pressure on the disc above. That is the risk of disc surgery-that you may need surgery on the disc above or below that site in 10 years or so. Don't know what your symptoms are but you have degenerative discs and some cord compression. Always try conservative first like the Dr. above states.

[AWG416]

Thanks for your comment, I appreciate it your taking time to offer your thoughts. The main symptoms over the past month have been tingling in my left arm and into my hand and fingers and weakness and shaking in my left hand. It has been over 10 years since my first fusion. I am in yoga teacher training so have had to modify my practice which is frustrating. I will try the conservative approach and see what the neurosurgeon says.

Thanks again,
Anne

[kay290]

Remember also that any nerve impingement that continues for too long can lead to permanent damage without surgery. But, as you know, surgery has its risks also so it is a catch 22. Get into PT also. If symptoms are going to resolve on its own it may take months (2-3). Good luck.