Question
Please interpret the following findings from my MRI which was done w/out contrast.  The findings were moderate spondylosis from C4 to C6. Slight anterior subluxation of C3 over C4. Moderate to severe right forminal narrowing of C4/C5 and on left side of C5/C6.  Small central disc protrusion C5/C6. Mild central canal stenosis at C5/C6 and C6/C7.

It sounds like I am in tough shape but I only have some pain and tingling down my left arm when I move my neck up.It is not present most of the time.  I am 61 year old female.

Are these findings heading towards surgery?

Thank you for your help!

Answer
Dear Paula,

These results are not as bad as you may think.  Although you have degenerative disc disease and arthritic changes to the spine, the magnitude of these changes is the most important thing to consider.

First some terminology:
Spondylosis = degenerative changes to the bone such as spurring
Anterior subluxation = forward slipping of one vertebra on another
Foraminal = holes in which the nerve roots exit the spine
Central disc protrusion = straight back towards the spinal cord
Stenosis = narrowing of the spinal canal or foraminal canals

Now the worst thing that I see here on the report is the severe right and left forminal narrowing visualized at C4/C5/C6. This is the most likely source of your arm pain (I am assuming pain is into the left shoulder and left forearm from this description).  However, with the symptoms you have described, you may be able to get by with spinal rehab exercises and traction rather than surgical intervention.  However, the degeneration cannot be reversed and if this progresses, you are looking at surgery to free up the area around those nerves which will eliminate the compression/irritation and thus eliminate the pain.

The small central disc protrusion and mild central stenosis is not that big of a concern.  Disc bulges can reduce over time by themselves, and have been shown to reduce with decompressive devices as well (many found in chiropractic offices).  Now...if the stenosis is caused by bony degeneration such as arthritic spurs, that is a different story, as these do not reabsorb.

If rehab techniques such as decompression or axial traction do not help (which is not likely) then the surgical procedure you would be looking at is called a foraminotomy, where they clean up the debris around the nerve and this is a fairly easy surgery to tolerate with high success rates.  Hope this helps Paula.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net