I have had a couple of lumbar discectomies (L4/L5 and L5/S1). In both cases I could trace these problems to specific injuries. Six weeks ago, I dove into a wave at the beach and felt a slight tweaking and got a stiff neck from it. I have also had pain radiating down my left arm, which particularly bothers me at night. Yesterday, I was at my dr.'s office looking at the MRI and to my surprise he said I need yet another surgery to treat the pain. Here is the radiologist's report on C5/C6 for the MRI:

C5/C6: There is a left foraminal disk herniation likely exerting mass effect on the existing nerve root. There may be a small amount of extrusion below the level of the interspace. The disk space is markedly narrowed. There is a moderate degenerative narrowing of the central canal. In the midline the thecal sac measures between 8 to 9 mm. There is moderate degenerative narrowing of the right foramen.

My dr. commented very quickly that I needed to have surgery to correct the situation. I remain shocked because just gauging from the pain, it doesn't seem to warrant surgery, as I had experienced much more pain and numbness from the lumbar problems from before. I have no pain that goes beyond my mid-forearm (none in my hand) and no numbness. The pain is also intermittent.

A few questions...... (1) is cervical pain less than lumbar pain in a disk herniation?; (2) I had an x-ray done 2 weeks ago while on vacation out of town and there was no comment about a narrowed disk space at C5/C6 or anything else regarding any levels, other than "degeneration is in line with age of patient" (I am 46). I know the MRI quality is vastly superior to an x-ray, but disk space should appear the same on both, correct? So why "the disk space is markedly narrowed" on the MRI but no mention of this on the x-ray?

Also my surgeon participates in clinical trials. A current one is for BMP (bone morphogenetic protein) for fusion procedures. He believes I should do a fusion. With all things being equal (insurance coverage, recovery time, long-term effects), what would you choose for C5/C6 - (1) a diskectomy (2) a fusion or (3) disk replacement? Does a diskectomy in the cervical area typically mean completely removing the disk and fusing?

THANK YOU !!!!