Chronic neck pain for over 20 years - successful C5-6 disc fusion in Dec01 (age39). Nov02, new C4-5 hernia with disc space narrowing. Neck pain on both sides with burning in both shoulder blades, caps, triceps, and neck. Both outer forearms and hands are mild to moderately numb. Simple neck movements frequently bite soft tissues with constant grinding/crunching. Aggresive PT and pain mgt has determined the pain is strictly related to the disc degeneration and resulting inflamation to soft tissues/disc/nerves. Steroid injection unsuccessful beyond a few days.
1. Please explain the following diag results in layman's terms:
- Myelo/CT: C4-5 central disc protrusion with anterior CSF space effacement; C2-3, C3-4, C6-7 central disc bulges with anterior CSF space mild effacement; C5-6 minimal central bony ridging; diffuse facet hypertrophy; no evidence of spinal stenosis.
- NCS: normal; EMG: Mar03-normal; Jul03-evidence of ongoing/chronic neurogenic process affecting multiple arm muscles, suggestive of chronic cervical polyradiculopathy involving C5,6,&7 root levels. Acute denervation in the left ECR and paraspinal muscles is further evidence of mild ongoing involvement at or proximal to the left C5 root level.
2. Based on these results - is surgery necessary at this time to prevent permanent nerve damage and if surgery is indicated, is disc replacement the only option? I'm hoping to hold off for flexi-disc FDA approval after clinical trials wrap up. Can a surgeon clean up the hernia and bone spurs (noted on x-ray) w/out removing the disc?
Thanks