Clinical Intake — Cervical disc degeneration

A 52-year-old male presents with an 11-month history of progressive neck pain, bilateral upper extremity numbness, tingling, and grip weakness originating at two adjacent spinal levels. He has since developed intermittent gait unsteadiness and a positive Hoffmann sign on the right, raising concern for early myelopathic changes. Imaging demonstrates degenerative spinal disease with foraminal narrowing and central canal compromise at both affected levels. Conservative management — two formal physical therapy programs, chiropractic manipulation, three epidural steroid injections, and ongoing pharmacotherapy with gabapentin and meloxicam — has failed to provide sustained relief; Dr. Patel refers for specialist surgical assessment.