Hello. I am a 35 year old male. Back in Feb. I woke up one morning with a stiff neck... over the next few days it got worse with pain radiating down my right arm. After 2 weeks I finally went to my PCP's office (was not able to see my PCP, but another doc). After a 5 minute evaluation, the doc determined I likely had "tennis elbow" and gave me a few exercises to do (Even though I told him there was no acute injury that I was aware of). Shortly after the visit the pain subsides, and is replaced with numbness. Sometimes just in my thumb, index and middle finger, other times all the way down the arm. After a couple weeks of this the numbness subsides and almost immediately pain and numbness start on my left arm, with only tingling in the 3 fingers on the right arm.
Go back to the doctors in April (again can't see my PCP and they give me the same doc as last time) and he orders an xray,
Here are those results: Four AP and lateral flexion/extension views of the cervical spine demonstrate anatomic lateral alignment with no instability on the dynamic views. There is slight leftward curvature within the mid cervical spine which may be positional and should be correlated as such. There is slight undulation of the inferior endplate of C6 which was present on the prior MRI. No acute injury is evident. The prevertebral soft tissues are normal.
There is mild degenerative disc space narrowing at C6-7.
IMPRESSION: Mild degenerative changes with mid cervical curvature and no acute abnormality of the cervical spine identified.
SO I have a followup in early May, and the same doc decides to put me on oral steroids. After a 9 day regiment I finally have releif to most of my symtoms.
Fast forward to my follow up the beginning of this month (June), and I finally see my PCP. He orders an MRI. I got the MRI results but I have yet to hear from the doctors office (called them once yesterday and this morning). Hoping someone can help me understand what these results mean and if surgery is a likely option.
TECHNIQUE: Multiplanar T1, T2, and STIR imaging was obtained of the cervical spine.
FINDINGS: There is straightening of the normal cervical lordosis. No listhesis is identified. No cord signal abnormality is observed.
C4-5: There are mild right spondylotic changes. No canal stenosis is identified.
C5-6: There is disc bulge mildly eccentric to the right with associated osseous proliferative changes resulting in severe narrowing of the right C5-6 neural foramen. The disc and osteophytic material likely contacts the exiting right C6 nerve root.
The left C6 nerve roots exit normally.
C6-7: There is a disc bulge with an osteophytic component, which results in mild ventral thecal sac impression. No significant canal stenosis or neural foraminal narrowing is seen.
The remaining cervical spine levels are otherwise unremarkable.
IMPRESSION: Eccentric disc bulge with osseous proliferative changes results in severe narrowing of the right C5-6 neural foramen. There is likely compromise of the exiting right C6 nerve roots. Please correlate with patient's symptoms.