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MRI showed disc extrusion, foraminal narrowing. No improvement with epidural injection. Tingling, numbness, weakness persists. Suggestions?

My MRI showed : Moderate to large left parcentral disc extrusion at L4-L5 with extruded disc material extending inferoiaterally into the left lateral recess of L5, displacing and impinging the traversing left L5 nerve root . Lambar neutral formainal narrowing is most pronounced at L5-S1 where is at least moderate potentially moderate to severe harrowing of the left L5-S1 neral foramen, more pronounced within the distal portion of the neural foramen. It s been 6 weeks since the finding, I ve had one epidural injection, no improvement. Pain not as great, but the tingling , numbness, weakness persist. I m an active cyclist & looking for best advice to get back to normal activity
Asked On : Tue, 8 Jan 2013
Answers:  3 Views:  49
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

Generally, the symptoms arising due to an EXTRUDED disc will not resolve completely with conservative management.

If your concern is only tinglng & numbness, Pregabalin & methylcobalamine combinations may help to certain extent but will not provide complete cure.

I personally feel that surgical decompression is indicated in you (because of persisting weakness in the involved muscles) either in the form of Endoscopic discectomy or Microlumbar discectomy which offers excellant outcomes.

So, I suggest you to approach a spine surgeon for further management.

Hope this information is helpful. Good day
Answered: Tue, 13 Aug 2013
I find this answer helpful

1 Doctor agrees with this answer

Neurologist Dr. Sudhir Kumar's  Response
Nov 2013
Hi,
Thank you for posting your query.
I appreciate the details MRI reports posted by you.
At this stage, you would benefit from medications such as pregabalin, which would reduce the tingling and nerve pain. In addition, physiotherapy with back extension exercises would help.
Surgery is reserved for more serious cases that do not improve with conservative management, as detailed above.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
My blog: http://bestneurodoctor.blogspot.com/
Answered: Tue, 13 Aug 2013
I find this answer helpful
Neurologist Dr. Sudhir Kumar's  Response
Nov 2013
Hi,
Thank you for posting your query.

I appreciate the details MRI reports posted by you.
At this stage, you would benefit from medications such as pregabalin, which would reduce the tingling and nerve pain. In addition, physiotherapy with back extension exercises would help.
Surgery is reserved for more serious cases that do not improve with conservative management, as detailed above.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
My blog: http://bestneurodoctor.blogspot.com/
Answered: Tue, 13 Aug 2013
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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