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Acute pain in the leg. MRI showing degenerative disc changes, nerve compression and annular tear. Advice on surgery

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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.
Posted Tue, 22 May 2012 in Bones, Muscles and Joints
Answered by Dr. Shiva Kumar R 1 hour later

Thanks for the query

From the details provided to me it looks like you are suffering from L5-S1 radiculopathy. Radiculopathy is a condition due to a compressed nerve in the spine that can cause pain, numbness, tingling, or weakness along the course of the nerve. Radiculopathy in you is due to mechanical compression (slip disc) of the spinal nerves exiting at the level of L4-S1 vertebra.

Fortunately, most people obtain good relief of their symptoms with conservative treatment like anti-inflammatory medications, physical therapy and avoiding activity that strains the neck or back. Most respond well to this conservative treatment, and symptoms often improve within six weeks to three months. If not one has to consider the option of epidural steroid injection or surgery.

Surgery is considered in the initial stages if one have sensory or motor deficits elicited on clinical examination.

So I personally feel if you do not have any neurological deficits on clinical examination you may be a candidate for conservative treatment. If radicular symptoms persists beyond 6-8 weeks or you develop sensory of motor deficits during the course of conservative treatment you may require emergency surgery to decompress the spinal nerves.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
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