### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
please refer the MRI CERVICAL SPINE which diagnosis as follow:- 1. Degenerative Changes 2. Congenitally Block CV7 and DV1 vertebrae 3. Myelomalacia at CV4-5 and CV5-6 levels 4. Circumferential bulge of disc with central posterior herniation at CV4-5 intervertebral disc level causing obliteratin of thecal sac and both lateral recesses witChatDoctorpression of the spinal cord . 5. Circumferential bulge of disc most marked at the left posterolatral aspect at CV5-6 intervertebral disc level causing indentation of thecal sac with narrowing of both lateral recesses and compression of the spinal cord. question is treatment possible via medicines rather than operation?

### output:

HiT hank you for your question. The treatment of cervical stenosis and myelopathy (spinal cord involvement) depends on signs and symptoms in addition to MRI. It would have been helpful to know the current symptoms. However, it is difficult to imagine having no symptoms with such an advanced stenosis picture. For the findings you have described unfortunately medicines won't help. When symptoms are progressive surgery is the only solution. Moreover, earlier the surgery better would be the outcome. The problem of cervical myelopathy is always progressive. Finding of myelomalacia indicates some damage to spinal cord has already occurred, and the cord must be decompressed surgically as early as possible to prevent further worsening. Also, risk of getting weakness in arms and legs is high even with a trivial fall or trauma to neck. Hope this is helpful. I would be happy to answer any questions you may have. Wishing the best outcome.