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Q. I have weakness and pain in the arm. Should I anticipate surgery?

Answered by
Dr. Chandan Mohanty
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 06, 2022 and last reviewed on: Aug 22, 2022

Hello doctor,

I recently had an MRI on my neck. I have a 75 % weakness and pain in the left arm (tricep). I have taken Methylprednisolone for six days. Should I anticipate surgery?

#

Hello,

Welcome to icliniq.com.

I am sorry to hear this. I have gone through your reports (attachment removed to protect patient identity). The MRI (magnetic resonance imaging) report shows pressure on the nerves in the cervical spine (neck). These nerves eventually go to your upper limbs. Hence the pain and weakness in your arm. Unfortunately, the report does say that the compression on the nerves is severe. Hence there is a high likelihood of you requiring surgery to relieve the nerve compression. Your surgeon will be able to make a decision based on your symptoms, clinical examination, and MRI results.

I wish you a speedy recovery. Best wishes.

Hello doctor,

Do you have an opinion on what type of cervical surgery is most appropriate? I am an elite-level rock climber.

#

Hello,

Welcome back to icliniq.com.

It is difficult to comment without seeing your scans and without examining you. Generally, the surgery can be done through an anterior approach (front of the neck) or from the back of the neck. Surgery from the back of the neck (laminoforaminotomy) may be useful since it can be done through a keyhole or minimally invasive approach, which will allow minimal removal/disruption of structures and hence faster recovery. However, please note that this is possible only if you are found to be the right candidate for it, based on your scans and clinical findings. Discuss this possibility and all your concerns with your surgeon.

I wish you a speedy recovery. Best wishes.

Hello doctor,

Would you consider a multi-level replacement? There are many options. Do you have an opinion on what is best for me? How long does it take for full recovery after surgery? A percutaneous endoscopic cervical discectomy was recommended, but there appear to be few surgeons that perform this procedure.

#

Hello,

Welcome back to icliniq.com.

There are numerous surgical options for you.

1. Artificial disc replacement

2. Anterior cervical discectomy and fusion.

3. Endoscopic discectomy.

4. MISS laminoforaminotomy.

5. Medical management.

Your C67 nerve compression has gotten better compared to the last MRI report. So all these five options are reasonable options with more or less similar outcomes, and it is a decision that has to be made by you and your treating surgeon. The average recovery duration after surgery is approximately 2 to 3 weeks.

Best wishes.

Hello doctor,

Thank you for your responses. I have uploaded my MRIs. Based on these images, would your opinion change?

#

Hello,

Welcome back to icliniq.com.

Unfortunately, my response is still the same. If your clinical and radiological findings correlate then the treatment decision is best taken by you and your treating surgeon.

Best wishes.


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