MRI was ordered for Occipital Neuralgia. I also have RA, PSA and Lupus overlap. Wanted to know if this is something that needs surgery. MRI: C4-C5 Severe spinal canal narrowing with compression of the cervical spinal cord between a disc osteophyte complex, subligamentous left paracentral disc extrusion and ligamentum infolding. Associated mild syringohydromyelia extending inferiorly from this level through thoracic spine likely related to impaired CSF flow on the basis of Canal stenosis