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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Herniated And Fragmented Disc In Epidural Space.

Hi there
MRI has shown at "L5/S1 a very large right paramedian focal disc herniation significantly compressing and displacing the origin of the right S1 nerve. There is associated sequestrated fragemented disc material in the epidural space compressing the thecal sac. The large complex herniated disc and sequestrated disc measures 1.6cm in length, 1.5cm in transverse dimension and 0.8cm in AP dimension"
I have seen a Neuro surgeon and am on a list for surgery to remove the fragmented disc.
I have been improving though whilst waiting. I still have a slightly numb foot and cannot do a calf raise (planter flex) but am getting though the day without pain medication now.
My Neuro rang me as I was writing this. He has suggested another MRI in 2-3wks (before surgery)
My question is should I have surgery at all or just keep going with gentle exercise and be patient.
Fri, 23 May 2014
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Orthopaedic Surgeon, Joint Replacement 's  Response
If there is marked relief in pain then you can wait for some time before surgery. You might not need surgery at all. This disease is having recurrent episodic nature so soon you may have pain again. But if pain is tolerable then there is no need for surgery. Whether you get operated or not, five year post results are same. Take pregabalin and Methylcobal tablet and wait. I hope you will be fine. If pain is increasing then get this surgery done.
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Suggest Treatment For Herniated And Fragmented Disc In Epidural Space.

If there is marked relief in pain then you can wait for some time before surgery. You might not need surgery at all. This disease is having recurrent episodic nature so soon you may have pain again. But if pain is tolerable then there is no need for surgery. Whether you get operated or not, five year post results are same. Take pregabalin and Methylcobal tablet and wait. I hope you will be fine. If pain is increasing then get this surgery done.