
Have Neck Pain. MRI Showed Moderate Changes Of Cervical Spondylosis. Any Advice?

Moderate changes of Cervical spondylosis.
Bilateral paracentral bulge of C3-C4 disc indenting bilateral exiting nerve root(left>right)
Right paracentral heriniation of C4-C5 disc indenting right exiting nerve roots.
Posterior bulge of C4-C5 disc is noted in thecal case
Posterior osteophytes noted at C5-C6 level indenting thecal sac on left side.
Left paracentral protrusion of C6-C7 disc indenting thecal sac and left exiting root.
Please advise me whether conservative medicines are better or surgery is necessary.
Thanks for sharing your concern with us.
You are really in a tough situation. As you have said there are only sensory symptoms and pain ( I suppose no muscle weakness) ,try conservative treatment first. However if there is muscle weakness or problem worsens with conservative treatment you may require surgery. Surgical options are
1. C456 corpectomy and fusion
2. By careful clinical examination and NCV, if it is found that only 1 or 2 of three discs (C34, C45, C67) are cause of your trouble and one disc bulge is not significant , you may again undergo discectomy at 1 or 2 significant levels, this time with artificial disc replacement.
3. Some surgeons may suggest a posterior laminoplasty .
Hope I answered your question. Let me know if you have any more concerns
Regards


How long I should try conservative treatment and opt for surgery.
Thanks for writing back.
Conservative treatment can be continued for any length of time , if your problem does not increase and your routine life remains largely unaffected.
If the symptoms become worse or start disrupting your routine, surgery needs to be considered
Regards

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