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Severe back pain radiating to knee, unable to walk, on steroid. MRI shows diffuse posterior bulge. Surgery required ?

h/o severe back pain radiating to knee,,unable to walk properly...put him on high dose of steroid and pain killer three time a day..MRI shows diffuse posterior bulge with small left paracentral protursion of l4 l5 disc compressing thecal sac and left budding nerve root .. diffuse posterior bulge of l1-l2 & l2-l3 disc intending thecal sac diffuse posterior bulge of l5 -s1 disc effacing anterior epidural fat,,,plz explain daes such patient need surgery?
Asked On : Sun, 16 Dec 2012
Answers:  3 Views:  47
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Neurologist 's  Response
Hello,
Your MRI and history is consistent with lumbosacral spondylosis with disc prolapse at multiple level, significant being the L4-L5 level with L) nerve root involvement. Decision to go for surgery depends on extent of weakness in L) lower limb . Just wait for the improvement with treatment planned presently.Avoid lifting weight and flexion of spine.Take absolute bed rest for next 2 weeks .Use lumbosacral belt for minimal daily activity .Take care
Answered: Sun, 16 Dec 2012
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Neurologist Dr. Sandhya Manorenj's  Response
Hello,
Your MRI and history is consistent with lumbosacral spondylosis with disc prolapse at multiple level, significant being the L4-L5 level with L) nerve root involvement. Decision to go for surgery depends on extent of weakness in L) lower limb . Just wait for the improvement with treatment planned presently.Avoid lifting weight and flexion of spine.Take absolute bed rest for next 2 weeks .Use lumbosacral belt for minimal daily activity .Take care
Answered: Sun, 16 Dec 2012
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Emergency Medicine Specialist Dr. Sheeba Stephen's  Response
Hello and welcome to Healthcare Magic. Thanks for your query.

The decision regarding surgery for disc prolapse is a clinical decision and cannot be done based on an MRI report alone. This decision will depend on a number of factors like:
- severity of symptoms
- degree of disability to the patient
- risk of further nerve damage due to the disc prolapse
- the choice of the patient

So, I would advise you to have a detailed discussion about the treatment options available with your treating doctor and then make an informed decision.

Best wishes,
Dr. Sheeba Stephen
Answered: Mon, 17 Dec 2012
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