Concluded Case

Cervical radiculopathy

New Case 72 yr M,Known DM 21 yrs,present FBs118mg/ ,HbA1c 6.8,presented with neck pain for 4 yrs aggravated since 4 months.Neck pain radiating to both side of neck to the occipital larea and both upper limbs Rt > left. Intermittent severe pain and at times he had difficulty in taking his food due to severe rt upper limb pain .Pain is shooting in character radiating down on either side up to RT thumb and left wrist.No difficulty in walking. On exam dulling of sensation C2 , 3,4 5 6 ,7 rt side and c56 on the left side.No long tract signs. What abnormality in the MRI?

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Thanks for all answers. On Pregabalin ,Gabapentin,cervical collor and physio for 1month. Tried anlgesics as well from out side.No relief. Ref to spinal surgeon. posted for elective anterior approach discetomy. MRI CS spine: *Loss of cervical lordosis.Degenerative marginal osteophytes noted along the anterior and posterior end plate regions at C3-4,C4-5,C5-6,C6-7 levels. * Desication and asymmetrical annular bulge causing bilateral mild neural foraminal stenosis at C6-7. *Desication and symmetrical annulus bulge of C3-4,C4-5 IV disc causing bilateral mild neuroforaminal stenosis. *Focal spinal canal stenosisC4-5,C5-6,C6-7 due to disc osteophytic compression . How ever cervical cord shows normal signals

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Thanks for all answers. On Pregabalin ,Gabapentin,cervical collor and physio for 1month. Tried anlgesics as well from out side.No relief. Ref to spinal surgeon. posted for elective anterior approach discetomy. MRI CS spine: *Loss of cervical lordosis.Degenerative marginal osteophytes noted along the anterior and posterior end plate regions at C3-4,C4-5,C5-6,C6-7 levels. * Desication and asymmetrical annular bulge causing bilateral mild neural foraminal stenosis at C6-7. *Desication and symmetrical annulus bulge of C3-4,C4-5 IV disc causing bilateral mild neuroforaminal stenosis. *Focal spinal canal stenosisC4-5,C5-6,C6-7 due to disc osteophytic compression . How ever cervical cord shows normal signals

Cervical spondylosis. Multiple level pivd with anterior and posterior osteophytes with reduceds disk space. With loss of lordosis. Neck hard collar, isometric neck excrcises, analgesics, gabapentin. Try conservative initially if no improvement, consult Neurosurgeon

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Yes mri suggest he has cervical spondylitis with pivd at multiple levels But at c2c3 and c3 c4 there is indentation of cord causing radiculopathy and comorbidies like diabetes of long standing 21yrs is contributing peripheral neuropathy

Thanx dr Rajendra Rai
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Classical spondylotic spine.. His symptoms match 5-6 radiculopathy..no myelopathy as per your description.. He should benefit with just simple c5-6 anterior micro discectomy

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Multiple level cervical degenerative disc disease intending cord Posteriorly ligamentum flavum hypertrophy adding to the insult Analgesics Gabapentin will help Soft cervical collar

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Cervical spondylosis with multiple disc prolapse,causing thecal indentation and root compression, PT 'S DM is very well controlled. Guarded conservative management with cervical traction, cervical collar, muscle relaxants , Pregabalin If there is worsening, Neurosurgeon opinion for surgery

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Degenerative Disc Disease of Cervical Cord (common in elderly) Radicular pain due to compression of nerve roots... Cervical Collar Physiotherapy

Thank you doctor
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Definitely c1 c2 destruction of bone c6 c7 disc space reduce osteophytes seen urgent orthopedic opinion and needful

Is there block vertebrae also in addition to what already

Cervical spondylytis with multiple level at PIVD,

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