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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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At C3-4 Moderate to severe disc space narrowing and endplate

Customer Question

at C3-4 Moderate to severe disc space narrowing and endplate spondylosis. There is concentric disc bulge L>R uncovertebral joint and facet arthrosis w moderate central spinal canal stenosis, AP diameter is 8.2mm, previously measured 9.1 , a year ago. Severe left an right moderate neural foraminal stenosis at this level.
C4,5,6 and 7 have been previously fused in past.
I have head and neck pain with movement and Lnubness in neck and shoulder, and anterior scapular area.
Should I see a nuerosurgeon or continue to try conservative measures and for how long.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hi Mary. From your description I would say you have a difficlt decision. Your problem looks like the most cranial level c3/c4 has made significant mocement into the spinal canal with significant spinal stenosis. You have tried conservativr measures with ablative treatments as well as transforaminal esi. The degree to which that can be extended is unlknown from this record but my advice based on the mri change over ghe last year would be at least to get the neurosugeons opinion. Please get back to me with quedtions and i will rrturn with a reply. Dr Frank

Customer: replied 1 year ago.
My concerning is that surgery will put stress on the disc at C2-3 level which has mild end plate spondylosis and minimal disc bulge L>R uncovertebral joint and facet arthrosis. No significant neuroforaminal or central spinal stenosis w AP at 13mm- essentially I think that means it's in good shape for now
Is the canal narrowing concerning at 8.2 mm at the c3-4 level- in the MRI impression it did say that the canal narrowing is mostly due to disc bulge and ligament in flavum thickening.- can this reverse itself?
Expert:  Dr. Frank replied 1 year ago.

The ligamentum flavum hypertrophy can be reversed but the central disc bulge will precipitate a spondylitic bar or doc which will indent the anterior thecal sac. The 8.2 mm AP diameter is critical despite the broadening at c2/3. I do not think that calcification can be reversed. That is my opinion as a neurologist. Maybe the neurosurgeon would feel differently. Dr frank