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Unable to stand on feet, MRI showed disc bulge and arthropathy. Line of treatment except surgery?

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Neurologist, Surgical
Practicing since : 1997
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MY GRAND FATHER IS UNABLE TO STAND ON HIS FEET HIS AGE IS 89 YRS. MRI SHOWS DIFFUSE PSTERIOR BULGE OF L5-S1 DISCS SEEN CAUSING INDENTATION OF VENTRAL THECALSAC & MILD CANAL NARROWING CONTRIBUTED BY LIGAMENTUM FLAVUM HYPERTHROPHY AND FACETAL ARTHROPATHY. we wish to know that what line of treatment is adviseable except surgery.
Posted Wed, 2 May 2012 in Brain and Spine
 
 
Answered by Dr. Shivakumar S. Kupanur 5 hours later
Hello.

Thanks for posting the query.

I have gone through the reports you have sent and it suggests age related changes.

There are some positive findings like disc bulge, mild listhesis which needs to be further evaluated with dynamic flexion and extension x-ray of LS (Lumbosacral spine) lateral view. He needs examination by a Neurosurgeon for other neurological deficits and ideally he require screening of whole spine to rule out pathology at higher level.

Considering his age and medical history of heart problem and hypertension, surgery is anyway not advisable for him.

Based on his MRI and clinical history, I would suggest the following treatment modalities.

1. If there is severe pain, he requires pain relieving medicines like anti-inflammatory drugs or Gabapentin.
2. Physiotherapy and rehabilitation will help him.
3. Epidural injections can be tried if pain is very severe.

Kindly get him evaluated by Neurosurgeon, so that necessary treatment can be initiated.

I hope, I have answered a query. Please accept my answer in case you have no follow up queries.

Regards.
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