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Herniated disc, numbness, quad weakness. Will the body absorb the disc fragments and relieve the pressure on the nerve?

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Neurologist, Surgical
Practicing since : 1997
Answered : 65 Questions
My husband has had a herniated disc at L2-L3 for four months, confirmed by MRI. (At the onset, he fell because his left knee "felt like jelly.") Pain has now almost 100% resolved with very conservative treatment (no prescription meds, no epidurals) and follow-up MRI at three months shows a decrease in size of herniation but there is still nerve compression. He has left XXXXXXX numbness and some left quad weakness. He is currently in physical therapy and left quad atrophy is slowly improving.

We have been to several orthopedic surgeons and a physiatrist. Some say give it a year, some say no surgery unless he gets worse, others want to correct every imperfection in his spine...he hopes to avoid surgery, but is discouraged by the slow rate of progress.

We have never had the opinion of a neurosurgeon about nerve compression. (We have been told that if a nerve is involved, get a neurosurgeon.) Might the body continue to absorb the disk fragments and thus relieve the pressure on this nerve? Is there a realistic timeline for this process? Is damage such as this reversible? My husband is 63 and in otherwise good health. We would be content to wait it out if we were sure that waiting is the correct way to go. Any suggestions on helping my husband or info on nerve healing would be greatly appreciated. Thank you so much!
Posted Mon, 21 May 2012 in Brain and Spine
Answered by Dr. Shivakumar S. Kupanur 7 hours later

Thanks for posting your query.

Based on your history, I understand that your husband has lumbar disc herniation at L2-L3, which has been managed conservatively.

Considering his asymptomatic status (no radicular pain), it is better to wait for a few months. Surgery is chosen when the radicular pain is severe with severe neurological deficits affecting quality of life.

Nerve compression can be relieved only by discectomy. The damage cannot be reversed, but, further progress can be slowed by physiotherapy and vitamins. A realistic timeline cannot be predicted. He needs regular neurological assessment and a repeat magnetic resonance imaging scan (MRI scan) to assess progress.

So, the bottom line is to wait before proceeding to surgery and repeat MRI after 3 months. Consult a neurosurgeon for a detailed neurological examination.

I hope I have answered your query. I will be available if you have any follow up queries.

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Follow-up: Herniated disc, numbness, quad weakness. Will the body absorb the disc fragments and relieve the pressure on the nerve? 6 hours later
Well, my husband would probably say that his quality of life IS being affected - he has trouble with stairs - but I could not honestly say his deficits are severe.

He has already had a second MRI, three months after the first, and it showed some reduction in the size of the herniation.

What vitamins would you recommend to help him improve? He already takes many vitamins and would gladly add to his regimen.

Thank you.
Answered by Dr. Shivakumar S. Kupanur 1 hour later
Hello again.

It is difficult to come to any conclusion without seeing MRI films and doing a neurological examination. However, with your description, it would be ideal to manage conservatively with regular physiotherapy and spinal exercise.

I advise you to assess him periodically. If any further symptoms arise, you should see a neurosurgeon to consider option of conservative treatment/surgery.

You can add Neurovitamins and Pregabalin can be used for pain and numbness.

I hope this explains your query. I will be available for follow up queries if any.

Wish you good health.

Above answer was peer-reviewed by
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