Rajesh Nair, hailing from Karnataka had been suffering from left arm weakness for the past seven years. He was diagnosed with C5-6 disc prolapse, a condition where the discs in the neck bulge out and press on the spinal cord, informs Dr Amit Sharma, a spine surgeon working at Jaslok Hospital, Mumbai. 

This causes disruptions in the communication pathway between the brain and body, leading to symptoms like pain, weakness, numbness or tingling in the arms and hands. Those dealing with this issue often experience a significant decline in their quality of life due to these troubling symptoms

Despite undergoing various treatments including physiotherapy, massage therapy and medication, the 59-year-old patient’s condition failed to improve, leaving him with limited mobility and function in his left arm. That’s when he consulted Sharma who performed a complex spine surgery on Nair to eradicate his restricted mobility and paralysis for seven years. 

Following a thorough assessment involving MRI scans and diagnostic tests, Sharma found out that the patient was suffering from spinal cord compression due to disc prolapse. He suggested immediate surgical treatment to address the nerve blockages and relieve the spinal cord compression.

Recounting the case study, Sharma tells us, “Patient came to us with weakness in his left arm for the last seven years. We ruled out any shoulder pathology by doing a shoulder MRI and consulting a shoulder specialist. The patient`s EMG-NCV, a test to check the functional status of the nerves, showed that the nerves in the cervical spine were affected.”

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He continues, “Due to the long-standing compression on the spinal cord causing weakness in the arm, it was difficult to predict the recovery after the surgery. The patient was explained about the uncertain nature of the results; however, having no other alternative, the patient wanted to take a chance by getting the surgery done. A C5-6 anterior decompression and fusion surgery was performed.”

“To everyone`s surprise, the patient claimed he recovered 60 percent on the very next day after the surgery. Clinically, his arm strength improved significantly compared to pre-operative status. He was discharged two days after the surgery. At 6 weeks follow-up, the patient regained 80-90 percent of his arm strength. 

What causes cervical disc prolapse?
Sharma informs that there has been a resurgence of cervical disc prolapse in the recent past. Cervical disc prolapse happens due to chronic wear and tear of the cervical discs. This is commonly known as cervical spondylosis. A sedentary lifestyle and lack of exercise, long working hours on computers, prolonged phone use and smoking are some of the reasons for increasing cervical spinal problems. 

The majority of the patients have mild symptoms, like neck pain and pain radiating to the shoulder and arms. These patients can usually be treated with medications and physiotherapy.  Physical therapy is advised to improve movement and strengthen the surrounding muscles. The goal of medication is to reduce pain and swelling. In more serious situations where non-surgical treatments fail to show good results, surgery may be needed to release pressure on the spinal cord and help restore regular function. 

Also, certain patients present with more severe symptoms like loss of sensation and weakness in the arms. These patients require urgent surgery to decompress the spinal cord so it can recover. If surgery is not done in a timely fashion, chronic pressure on the spinal cord can damage the nerves leading to permanent numbness and weakness. Even though the chances of recovery of these patients with long-standing spinal cord compression causing arm weakness is very low, an effort should be taken to do whatever is in our hands. And miracles do happen, as we saw in our patient`s case. 

The main goal of treating a C5-6 disc prolapse is to reduce pressure on the spinal cord. During surgery, the existing spondylotic cervical disc is removed and the spinal cord is decompressed. The empty space created due to disc removal is usually filled with a spacer and bone graft. Patients usually feel immediate relief from pain. 

However, it takes a few weeks for the tingling numbness to recover, and it might take a few months for the weakness to improve. Patients can perform all daily routines within a day or two after the surgery, including going to their work. They are advised to stay away from heavy work for 3-4 weeks, after which they can resume all normal activities. 

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