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Which specialis should be consulted for degenerative changes in vertebral spines with disturbance in spine structure?

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General & Family Physician
Practicing since : 1969
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My GP doesn't know who to refer me to. I have several bulging disks and a ruptured disk between L4 and L5 according to my MRI results. Need to know who I should best see. Pain is excruciating only for moments; however, I have numbness radiating down my leg. I have been proactive in my treatments (chiropractic - which I have now ceased due to the rupture, accupuncture - which assists with pain management, and massage therapy). I am an equestrian and have not been in the saddle since the ruptured disc. Not sure what to do in the interim in the way of exercise. I am afraid to do anything and he only said walking was allowed. I need to be able to do more, but am not sure what I can do. Please recommend exercise and a specialist. from the MRI ... At L4-5 ther ia milde disc height loss present. A large right paracentral disc ptrotursion is present which measure sup to 7.6 mm in AP dimension. This displaces the traversing right L5 nerve root posteriorly adn compresses the nerve root. There is approximately 6 mm in inferior migration of the disc protrusion. Inferior to the disc protrusion, there is an extradural mass present in a right paracentral location at the level of te L5 vertebral body measuring up to 7.7 x 8.9 mm in transverse dimension and spanning craniocaudead distance of approximately 12.9 mm. This extends inferiorly to the level of the right L5 S1 lateral recess and appears to compresses the traversing right S1nerve root. This mass follows the spnal characteristics of nucleus pulposus and is most compatible with a sequestered disc fragment. At the L4-5 level there is also moderate right and marked left facet hypertrophy with a moderate degree of left and mild to moderate degree of right foraminal narrowing. Th exiting Left L4 nerve root is contacted in teh nerual foramen. At L5-S1 the right paracentral extradural mass felt to represent a sequesterd disc fragment compresses the traversing right S1 nerve root. There is moderate to marked facet hypertrophy. Marked right-sided foraminaal narrowing is present with further compression of the right L5 nerve root. Miled left foraminal narrowing. At T1-L1 minimal diffuse disc bulge, no spinal stenosis or foraminal narrowing At L1--2 there is no spinal stenosis or foraminal narrowing At L2-3 there is a mide diffuse dic bulge. This is slightly more prominent in a left paracentral loation. There is mild to moderate facet hypertrophy. Tehse findings cause mild flattening of the tecal sac. No spinal stenosis. No foraminal narrowing. At L3-4 there is a milde to moderate diffuse disc bulge. Tehre is milde facet hupertrophy. These findings cause flattening of the tecal sac. No spinal stenosis. Minimal bilateral foraminal narrowing is seen. IMPRESSION athte L4-5 level there is a large right paracentral dis ptrotrusion iwth inferior migration compressing teh traversing right L5 nerve root. Inferior to this there is what is most compatibble with a sequestered disc fragment which also compresses the right S1 nerve root. A neurosurgical consult is recommended. I live in Surrey BC and would like a recommendation of a Nerosurgical consult.
Posted Sat, 11 Jan 2014 in General Health
Answered by Dr. Ramesh M.Vachharajani 3 hours later
Brief Answer: Consult spine specialist and neurosurgeon Detailed Answer: Hi, XXXXXXX barber, Thanks for posting query. Studding long and very informative MRI report I recommend to consult, 1, Spine specialist as there is much problem and many degenerative changes in your vertebral spines with disturbance in spine structure. You may require surgical procedure as well. 2, As there is nerve involvement due to pressure or irritation of nerves passing through affected vertebrae, consultation of neurosurgeon is also advisable as well. Combine opinion of both specialists will be helpful for further line of treatment. You can ask to your doctor for best spine specialist and neurosurgeon in your state. I hope, I answered your query. If you have further query or clarification, please write back. Wish you sppedy recovery.
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