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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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MRI Shows Nerve Root Compression, Facet Arthrosis Without Stenosis. Should I Consult A Neurosurgeon Or Orthopedic?

Hi I m 45 year old female (5 6, 135lbs) who is athletic and injured my back doing a 135lb deadlift incorrectly about 4 weeks ago. I ve rested, iced, pain meds, muscle relaxers, exercised, stretched, etc. Just got MRI esults back and referral to a neurosurgeon but I m waiting to see if they will even accept me as a patient. MRI results are: 1. At the L5-S1 level, there is a posterolateral disc protrusion on right which displaces & possibly compresses the right SI nerve root . Facet arthrosis w/out stenosis at this level. 2. At the L-4-5 level very mild facet arthrosis without stenosis. I m in a lot of pain and need to get this fixed as taking pain meds is not a solution for me. Should I be seeing a neurosurgeon or orthopedic and is this something that can be fixed surgically or will it take physical therapy over weeks and months, etc. I m in recovery and sober and I can t be in a situation where I m in this much pain and having to continue on pain meds. I m also very athletic and have a family to take care of. I can t get into see a neurosurgeon for another 3 weeks and just want to be sure he can help me or if I should be looking for another doctor and thus a solution like injections , etc. Thank you so much.
Wed, 19 Dec 2012
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hello.
Thanks for posting your query.

You are suffuring from PIVD at l5/s1. Due to this Disc bulge pressure occurs on nerve roots & radiation of pain occurs in that dermatotome. Physiotherapy like intermittent lumbar traction , back exercise reduces pressure of disc bulge for some time & gives relief.

According to severty & patient demand surgery is a good option (Discectomy). Nowadays Microdisectomy done with an operating microscope. Exposure is very limited. Morbidity & hospitalisation is less.

So you can consult an orthopaedic or neurosurgeon for detailed examination and discuss about surgical options.

Wishing you good health.
Regards.
Dr Saurabh Gupta.
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MRI Shows Nerve Root Compression, Facet Arthrosis Without Stenosis. Should I Consult A Neurosurgeon Or Orthopedic?

Hello. Thanks for posting your query. You are suffuring from PIVD at l5/s1. Due to this Disc bulge pressure occurs on nerve roots & radiation of pain occurs in that dermatotome. Physiotherapy like intermittent lumbar traction , back exercise reduces pressure of disc bulge for some time & gives relief. According to severty & patient demand surgery is a good option (Discectomy). Nowadays Microdisectomy done with an operating microscope. Exposure is very limited. Morbidity & hospitalisation is less. So you can consult an orthopaedic or neurosurgeon for detailed examination and discuss about surgical options. Wishing you good health. Regards. Dr Saurabh Gupta.