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MRI results - will I need Surgery?

I am 55 year old type 1 diabetic (diagnosed 1992) who has had severe pain in hands and lower arm for the last 3-4 years. Mild pain has been going on for a lot longer. Back muscles from botton of spine to shoulders are also very tight and commonly in spasm. I have had a facet joint injections at L5/S1 and T6/7 to releieve pain at these points which was reletively successful. I have DDD at L5/S1 and L3/4 with bulging at T6 - T8. I do pilates for 2 hrs a week and have a sports massage every 3 weeks. Without these I think I would seize up. Pain in lower back was controlled by 50mg diclofenac and occasional pain killers.

I had an MRI done 2 years ago and one recently due to the arm pain which was occuring and the differences are quite marked. In the same time I have added chest soreness (mainly on left side in floating ribs) and it will occasionally spasm causing tightness for a couple of seconds which can make it hard to breathe.

Over the last 4 years I have had both carpal tunnels released which has removed some of the parathesia and numbness but not stopped the aching pain which is continuous. I have also seen a neurologist who could not find any neurologicl deficit but has treated it as if it was neuropathy with duloxetine ( I take 90mg a day) together with Tramadol 50mg and co-codamol 30/500 as required. My Endrochronolgist says that this is not diabetic neuropathy. In the last 3 years I have also had an attack of thyroditis with no apparent long term affect.

My MRI results are as follows:

Summary only:


There are minor degenerative changes within the cervical discs. There are shallow broad based discal bars at C3-4, C5-6 and C6-7 levels. The canal dimensions at these and other levels are adequate throughout. Bilateral uncovertebral osteophytes are resulting in moderate constriction of the C7 neural foramina with potential for root impingement. Minor disc bulges at T5-6 to T7-8 levels are not resulting in neural impingement.


At C3-4 a disc osteophyte bar causes marked bilateral foraminal C4 narrowing.

At C5-6 a broad based disc protrusion reaches the ventral aspact of the spinal cord (without causing cord compression) as well as causing moderate to marked degree of left C6 foraminal narrowing. This protusion has slightly increased in size since the previous study.

At C6-7 a broad based disc-osteophyte bar causes marked bilateral C7 foraminal narrowing.

Thoracic outlet and brachial plexus appear normal.

I have been referred to a spinal neurosurgeon and would like some help intepreting the above and an indication of the likelihood of surgery.

Regards Malcolm


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