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Acute sciatic pain. MRI shows lmbar spondyolosis, diffuse disc bulges at L4-L5, L5-S1, secondary canal stenosis. Suggestions?

I am suffering from an acute sciatric pain.. Plz guide me about the treatment that i shoud go for...following are the results of my mri report. Lumbar spondyolosis with diffuse disc desiccation , diffuse disc bulge with posterocentral protrusion with annual tear at l4-l5 level causing bilateral foraminal narrowing widout definite nerve root compression, diffuse disc bulge with central and left paracentral protrusion at l5-s1 level causing bilateral foraminal narrowing with compression upon bilateral traversing nerve root (l greater than r) and secondary canal stenosis
Asked On : Sun, 13 Jan 2013
Answers:  3 Views:  168
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Neurologist 's  Response
The MRI report of yours shows that there is disc protrusion and compression over the nerve roots. Your symptoms are explained by this compression. The treatment options include medications, surgery and physiotherapy. Physiotherapy is necessary in all patients. If there are no definite deficits (like sensory loss or weakness) then trial of medications with bed rest can help most of the patients. If medications are not helping or if there are deficits, then surgery is recommended. You neurologist/ neurosurgeon/ spine surgeon can guide you on this.
Good luck.
Answered: Mon, 14 Jan 2013
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Neurologist, Surgical Dr. Visvanathan K's  Response

It looks as if you have a slipped disc at the L5/S1 level which is compressing the sciatic nerve root. From the MRI description, it is likely that your sciatica will be more on the left than the right. Further, there are degenerative changes seen on the level above as well, though not as serious as the one below. You need to be assessed by a surgeon who deals with these problems to what the clinical findings are. After correlating your symptoms with the findings and MRI, he/she will basically lay on the table 3 options:
1. painkillers and other non interventional measures
2. Nerve root block
3. Surgery

The order in which the 3 are offered to you depends on your symptoms, clinical findings and MRI picture. Most sciaticas settle down after a few weeks with painkillers etc and that would usually be the first course of treatment for the vast majority of patients.

Hope this helps
Answered: Mon, 14 Jan 2013
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Spine Surgeon Dr. S K Mishra's  Response
Your problems are significant. Consult spine surgeon , and depending on your clinical findings you require surgery/conservative trial.
Answered: Mon, 14 Jan 2013
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Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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