What Does My MRI Test Result Indicate?
I answered the question on medications wrong, I have not tried any meds I don't have pain enough to be on medications really. Just Ibuprofen prior to this but off of any meds now due to surgery.
If cord compression signs it is necessary.
Detailed Answer:
I read your question carefully and I understand your concern.
Indications for surgery are often a subject of debate, opinions may vary among physicians, some are more aggressive than others. Looking at the imaging reports I believe the level which mostly worries your doctors is the C4-C5 one where the disc herniation is indenting, which means it may be compressing the spinal cord. For the moment it hasn’t caused irreversible damage, no myelomalacia, but they want to prevent that from happening, especially considering that the bulge has increased compared to prior exam.
Now I understand that you consider the pain manageable, but when it is a case of cord compression it is not only the pain which has to be evaluated. Cord compression may lead to weakness of the muscles of the upper and lower limbs, trouble with balance and coordination, difficulty performing daily tasks. So if apart from the pain there are signs like increased reflexes, muscle weakness and atrophy, combined with compression of the spinal cord, then that compression has to be relieved before it causes irreversible changes.
For that reason if there are such manifestations I would say the surgery is really necessary and you should do it. If you are fully functional and no such manifestations are found (but that has to be discussed with the doctor who makes physical exam, not necessarily signs noticed by patient) then decision for surgery is debatable, a wait and see tactic, continuing with physical therapy, may be chosen.
I remain at your disposal for other questions.
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Detailed Answer:
Hello again.
I must say I find your perplexity justified.Judging by the MRI report those fusion levels seem to be just fine, do not cause any stenosis, so I must say I am not that sure about what he intends to clean up really, unless he sees something else than the report. As I said I can agree with surgery for the C4-5 level where there is the compression worry (due to the stenosis by the bulging disc), not sure about such an aggressive approach. So I would discuss that with him again.
As for recovery times it depends by what one means by that. The time for the fusion itself to happen, to merge together, is 3 months. Exercises programs possibly under the guidance of a physical therapist are recommended afterwards though, so full recovery takes about 6-8 months in that sense (but that doesn't mean you will not be active for that long, you should be back to most normal activities after 3 months - if not physically strenuous can resume work).
Let me know if I can further assist you.
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Detailed Answer:
Sorry for the late answer, had a very busy start of the week at the hospital and couldn't manage the time.
It is true that the CT report speaks of osteophytes narrowing the spinal canal, but usually between a CT and a MRI, the MRI is regarded as the more accurate exam in evaluating canal stenosis, so I gave my opinion based on the MRI report. So while the CT report makes the decision to interven on those levels more understandable, I still would be reluctant to operate on those levels with that MRI report. If the MRI report had sounded inconclusive (which may happen due to the metallic artefacts) I'd have understood, but the MRI report doesn't mention anything of the kind and states there is no stenosis.
As for what osteophytes are, they are bony spurs created over the years, part of the arthritic changes taking place in the spine. Whether they cause any symptoms depends on the direction they grow, whether they cause any compression or stenosis. So if growing in the direction of the spinal canal they can cause stenosis. It is something which is not solved by fusion, fusion deals with the intervertebral disc as another cause of stenosis, not with the osteophytes which can continue to develop whether a fusion is successful or not and may require surgery.
I hope to have been of help.