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Acute pain in left leg, mri report suggests degenerative disc changes with pivd l4l5, l5-s1. Advise? - Online Doctor Chats

Date : 28-May-2013
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User:I am having acute pain in left leg and my mri report says F/S/O Degenrative disc changes seen with PIVD L4L5, L5-S1 causing compression of B/L nerve root at L4-L5 left right and of the left at L5 S1 mild compression of left nerve root also seen at L3L4 Type II annular tear seen at L4L5 Level. Kindly suggest whether operation has to be done. and what are the risks.
Doctor:May I know your age?
Doctor:Since when are you having these symptoms?
User:seven days
Doctor:Has the pain worsened since the onset
Doctor:Do you feel weakness of leg, difficult in walking?
Doctor:Any problem passing urine?
User:yes I am not able to walk only, no problem in passing urine
Doctor:Let me explain.
Doctor:The MRI reveals some problem -
Doctor:there is a part of disc which is compressing on some nerves in the lower part of the spine.
Doctor:This might be causing the pain and the weakness.
User:do i need to go for an operation or are there other remedies
Doctor:This can be managed with medication, physiotherapy, epidural injections.
Doctor:Surgery is needed if there is nervous dysfunction secondary to the compression.
User:My physician has suggested to go for an operation for relief, should I take a second opinion
Doctor:Getting a simple test known as EMG will help us know
Doctor:if surgery can make a difference.
Doctor:Since surgical treatment is not completely foul proof
Doctor:I suggest you to XXXXXXX a neurosurgeon
Doctor:who will perform the test
Doctor:and then plan for surgery only if needed.
User:Will the EMG show whether it can be treated without operating it.
Doctor:EMG will reveal if there is nerve dysfunction secondary to compression.
Doctor:If there is then it needs to be surgically corrected immediately.
Doctor:If there is no much dysfunction,
Doctor:then the condition can be managed conservatively
Doctor:by means of physiotherapy, pain medication and rest.
Doctor:Have you followed what I suggested?
User:Are there any risks associated with the surgery
Doctor:Spine surgery is associated with few problems.
User:what are they
Doctor:Apart from the usual complications, nerve injuries can occur.
Doctor:Further in some cases, the pain can be persisting despite surgical intervention.
Doctor:It needs to be performed only when there is nerve dysfunction and when conservative management fail to give you relief.
Doctor:So consulting a neurosurgeon / back surgeon is the best thing you could do now.
Doctor:The usual complications associated with surgery are
User:My doctor who is a neurosurgeon has only done MRI and has suggested me to take the operation because of the pain which is worsening from day to day and all the pain relief medication has also failed to give relief
Doctor:bleeding and infections.
Doctor:If there is no significant weakness and if EMG has not been done,
User:The pain is so much that after taking sedative diazepam also I can't sleep at night
Doctor:you could still take a second opinion from a different spine surgeon.
Doctor:however if there was no much relief with medication,
Doctor:then surgical treatment as your doctor suggested needs to be planned sooner.
Doctor:Do you follow?
Doctor:Do you have any other query?
User:thanks I will take a second opinion from another neurosurgeon.
Doctor:You are welcome.
Doctor:Let us know if you need any other help.
Doctor:Wish you speedy recovery.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
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