Neck Herniated Disk; What Severe Means.
Recently, I saw a new patient, who came in with neck pain. As I looked at her MRI reports, the radiologist report said, “large herniated disc at C6-7 to the left with severe canal narrowing.”
That instantly grabbed my attention.
Huge RED FLAG!
The first thing is to look at the MRI images and if indeed it is large and looks severe, it is time for a long discussion.
Right behind the disc lies the spinal cord and nerve roots. Behind that is the bony facet joints and lamina.
Further compression of either the spinal cord or nerve roots upon a hard honey structure can be a catastrophic spinal cord injury.
The MRI was 6 years old. She was late 50’s, gained weight and had been in 2 car accidents. Her neck pain was increasing. No Physician had impressed upon her the significance of her neck problem, in fact she was a care giver for her husband which required heavy lifting. Her complaints were numbness in the left arm, all fitting with her MRI.
Her physical exam revealed just some sensory changes.
It was time for a new MRI, and some detailed discussions. Patients are thankful for honesty and spending the time to adequately explain their problems.
That is how medicine should be.
