Brief Answer:
Means that you have 2 small herniated discs in your neck

Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I'm a neurologist from XXXXXXX Ohio, USA.

You have a small "herniated disc" at the level of the 4th and 5th cervical vertebral bodies. Herniations are extrusions of some bodily material into a place that it's not supposed to be. In this case what is "herniated" is the central gelatinous or GOOEY portion of the disc (nucleus pulposus) or shock absorber that sits between each pair of vertebral bodies of the spinal column. This shock absorber is the DISK. The disk has a center which is gelatinous and an outer part which is rather rugged and fibrous which surrounds the inner layers of the disk. This outer tough shell is referred to as the annulus. Can you think of what a TOOTSIE POP is like? The hard shell on the outside surrounding a gooey center that never gets out unless you CRUNCH through the hard layers?

So when the soft gelatinous material which gives the disk its shock absorber qualities "breaks out of its usual location and pushes into the outer layers of the annulus it can continue to PUSH its way entirely out of the disk by breaking through the TOUGH FINAL ANNULAR BARRIER which then, means that the goo is now into the spinal column which will allow it to compress nerves and ligaments.

Or the GOO may NOT breach the out annular layer and stay right at the brink of the annular wall without "bustin" out into the spinal column or from between the vertebral bodies. If that happens then, the hernia is referred to as SUBLIGAMENTOUS. Cranial simply refers to the direction that the PUSH and abutment of the goo are headed which would essentially be UPWARD (toward the head...hence cranial).

The report also mentions that in addition to the RIGHT sided push of the GOO there is another herniation 1 level UP from that one (C4/5). In that herniation, however, there is an amount of the nucleus pulposus (the GOO) which is pressing straight down the midline or central portion of the disc. So there are 2 small herniations in your neck at consecutive levels.

This could be causing pain or discomfort in the neck and possible radiation of pain, numbness, or tingling down the right shoulder to the level of the mid-arm. Or there may not be very much in the way of the numb or tingling sensations just yet since the GOO hasn't really escaped from the disk so that it's not PRESSING on anything. Nevertheless, I predict that you have at least some good pain in the center of the neck accompanied by possibly some stiffness or muscle spasms.

Between those 2 herniations the one that is likely to cause problems with pinching nerves is the one going to the right. The one which is going to the midline is unlikely to cross the path of any spinal nerves since they exit from the right and left typically. So the one that would be problematic in the future if it actually passes the level of the annulus (i.e. no longer SUBLIGAMENTOUS) and oozes out would be the herniation to the right at C5-6.

I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your question has been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 60 minutes of physician specific time to read, research, and compile the return envoy to the patient.

---

Brief Answer:
I would not recommend surgery

Detailed Answer:
I do not recommend surgery to patients until all reasonable and possible resources and options of a conservative nature have been tried and failed. In your case, I don't know what you've done or what you haven't done but I can tell you that of patients with similar problems surgery has rarely been a cure all and often times other problems develop that were never present before. Not only that but the whole cervical spine could be destabilized if someone does a laminectomy or fusion procedure which is really not indicated or necessary.

If any surgery could be done for your problem I believe it should be one of a minimally invasive sort but again, NOT NOW....that might be down the line when everything else has been tried and/or failed. I would not endorse a radical neck procedure for what your scans show....that's so 20th century! LOL!

50% of herniated disks will resolve themselves without any surgical intervention and just with conservative physical therapy, appropriate medications,
aquatherapy, etc.

I'd appreciate your providing a STAR RATING and some written feedback if your questions have been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 85 minutes of physician specific time to read, research, and compile the return envoy to the patient.

---