What Causes Pain In Right Arm Radiating To Hands And Finger?

i had a fusion at c5/6 6years ago successfully. Now have herniation at c3/4 abuting cord. have pain in right arm radiationg into hand and fingers , between shoulder blades right shoulder and occipital area. Also have stinging sensations in arms and legs nausea and occasional dizziness. have tried pt, analgesia and all conservative treatments. will I need surgery and would it be advisable to have c4/5 fused at same tiem. thank you.