Conversation: The conversation between human and AI assistant.
[|Human|] I am a 71 year old U.S. Marine Vietnam combat vet..I am a diabetic, COPD, PTSD, heart disease and a pacemaker...The VA told me I need neck surgery to put the vertebra back in place....However, the VA does not have a neuro surgeon so they have the New Mexico University Medical Center working my particular case. I have a very large lump on the right side of my neck that was misdiagnosed as a tumor. I have aggravating lower back pain and lose periodic mobility in both arms... UNMC has advised a milo-gram and that I am at great risk for any procedure at this point. Do you have any suggestions ???
[|AI|]  Hi, Judging from your description the cause of your symptoms would be degenerative changes of the spine with the formation of disc bulges (herniation) and bony spurs (osteophytes). Such changes may cause local inflammation, compression or nerve roots and spinal cord, so could be responsible for the back pain due to inflammation and arm deficits from spinal cord compression. In order to confirm the diagnosis and determine whether surgery is needed, type of surgery and risks imaging is necessary. The best way would be MRI, but that might not be possible as you carry a pacemaker, so that might be why a pyelogram was advised. It should be done, any decision regarding surgery or other approaches is heavily dependent on imaging information I am afraid. Hope I have answered your query. Let me know if I can assist you further.