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effacing cervical ventral thecal sac
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effacing cervical ventral thecal sac

Hi
I recently had gone to my ortho because of left arm pain/numbness/tingling. He wanted an MRI of my neck. The MRI results: c4-5 there is a 2mm focal central disc protrusion effacing the ventral thecal sac. c5-6 there is a 4mm left paracentral broad based disc protrusion effacing the ventral thecal sac of a congenitally small spinal canal with reduced AP dimension secondary to "short pedicals"(possibly compromising the left c6 spinal root). Neither of these show any cord compression.There is paucity of spinal fluid in the mid region of the cervical canal due to stenosis.

My question is this: will I need surgery?? If this goes untreated can it lead to paralysis?? My ortho has also indicated a finding of bilateral clonus in lower extremities. I have done some research regarding clonus, and have found that it is a upper motor neuron "problem"( brain or neck) and would/could show hyperflexion. Could the clonus be due to the MRI results?? I live in California and only have state funded insurance "medi-cal" and have very little confidence in these doctors because of prior treatment. Last year I had gone to a Medi-cal neuro and he indicated in his report that I had hyper reflexes at that time, yet he never asked for an MRI of my neck.

All of this has started after a tumble down the stairs in my apartment. I posted earlier in regards to left leg instability, which also was a result of the stair incident.

Any help/feedback would be greatly appreciated. Sorry if my statements are not clear enough

Thank you.
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Without reviewing the film I cannot state if surgery is necessary. Cervical stenosis (narrowing of the space within the spinal canal in the neck) can lead to increased reflexes in the legs, and if it progresses could cause weakness. A conservative trial of anti-inflammatories may be indicated to see if your symptoms will improve. Unfortunately the decision to move to surgery is difficult and requires examing you and reviewing the films. I would recommend asks the ortho doctor if surgical therapy is indicated, and what are the risks associated with not moving towards surgery. If you choose not to proceed to surgery and in the future develop weakness in your limbs, or bowel/bladder dysfunction you should seek immediate medical attention. Good luck.
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Forgot to mentionthat I am a 39M, otherwise healthy.
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Thank you so much for your information !!
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