Expert: Scott F. Gillman, DC, DACBSP - 1/4/2009

Question
My husband has been having severe neck pain and pain shooting down his arm for the past 6 weeks.  We just picked up the MRI report.

He has multilevel stenosis due to a combination of developmental and degenerative disease. Stenosis is worst at c 5-6 where there is moderate to severe narrowing of the central canal and broad based posterior spondylitic ridging with disc osteopohyte complex effacing the ventral thecal sac with flattening of the ventral aspect of the cord. The cord is bowed posteriorly at this level. There is bilateral unvcoverterbral joint hypertrophy with bilateral neural foraminal narrowing. There is moderate narrowing of the central canal at C 3-4 and mild to moderate stenosis at  C 4-5 and C 6-7

Given a profile like this, is my husband a candidate for chiropractic treatment or is he past less invasive treatments and a surgical candidate.  How would chiropractic treatments help when a bone spur is actually compressing the spinal chord?

Answer
Amy,

The "moderate to severe narrowing" at C5-6 makes me quite cautious against any high velocity manipulation.   If he is neurologically in tact, meaning that he has normal reflexes, muscle strengths, and skin sensation (vis. pin prick, pinwheel, light touch, etc) then maybe he could tolerate gentle neck tractioning by hand and then graded mobilization to his tolerance.  If he has loss of reflexes, weakness to muscle strength, e.g. grip strength, or biceps strength for example, then I would caution against any manual therapy until he has a neurosurgical consultation.   He may be a surgical candidate and that could be his best source of relief and surely his only source of long-term resolve.   In summary, given what you've told me, your husband is best suited to a neurologic evaluation and surgical consultation.  If the surgeon says no to surgery, then he could try the manual theray I described above.

'Hope this was helpful.

Dr G