An xray showed dynamic instability at c3 and c4. i have been having a lot of pain. is dynamic instability something that requires surgery?

Discuss with a neurosurgeon, as the surgical decision is based on the size of the motion between the vertebral bodies. Key is risk of contact damage to the spinal cord, and at the C3-C4 level, secondary involvement of phrenic nerve can lead to risk of breathing cessation. Definitely use a hard cervical collar at this time, as a temporary protective device.

Ask that question of the physician who ordered the test. Good Luck