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Treatment for Lumbar radiculopathy with severe canal stenosis

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Spine Surgeon
Practicing since : 2002
Answered : 102 Questions
what is the treatment for
Lumber radio lopathes pain severe canal stenosis
Posted Wed, 11 Apr 2012 in Back Pain
Answered by Dr. Krishna Kumar 17 hours later

Thanks for the query.

From what I understand, I assume you are asking for the treatment of lumbar ‘radiculopathy’ with severe canal stenosis.

There are mainly 3 kinds of treatment available for this condition, namely:
1. Medicines and physiotherapy.
2. Epidural steroid injection to the back.
3. Lumbar decompression surgery with or without fusion.

Your primary healthcare provider after careful examination will be able to decide the best and feasible treatment of your problem from the 3 available treatment options.

Hope I have answered your query. I will be available to answer any further queries that you might have. Please accept my answer if you do not have any other query.

Above answer was peer-reviewed by
Follow-up: Treatment for Lumbar radiculopathy with severe canal stenosis 21 minutes later
What I wanted to know is in my mothers case we did 2 MRIs in 30 days span and then a PET SCAN (impage enclosed).

MRI does not show any infection but the bone scan had some finding.

The pain has not subsided for last almost more than a month.

Can suggest next steps in the treatment,
Answered by Dr. Krishna Kumar 1 hour later

Thanks for follow up query.

I have gone through the bone scan report, it does not catagorically say that your mother has infection. It is more in favour of degenerative changes.

Infection can be picked up by simple blood tests such as altered ESR (Erythrocyte sedimentation rate), CRP (C-Reactive protein), Blood count, etc apart from MRI.

I did not find the MRI report and I suggest you do get the following x-ray series done.
X-ray LS (Lumbosacral) Spine - standing- lateral flexion and extension.

I would like to know the patient's detail history rather than just a copy of reports, as it is quite difficult to answer without knowing the details of the person suffering. So, kindly provide me the details like patient's symptoms, duration of present complaint, severity, any treatment undertaken, etc.

Hope, this answers your query. Please reply back with the answers to my questions, so that I can provide more specific suggestions.

Wish you and your mother a good health.

Above answer was peer-reviewed by
Follow-up: Treatment for Lumbar radiculopathy with severe canal stenosis 18 hours later

First thanks a lot for your response.

Age : 67 Female, Diabetic and Hypetention. (Angioplasty done around 8 yerar back)

The history of pain and medication:

The lower back and seviour leg pain started early Octomber'2011 and by 24th october she was unable to sleep in the night due to pain.
This pain starts from the back of hips and radiates down the leg. The pain is severe in right leg and mild in right leg.

We consulted a neurologist 0n 11 Nov'2011 and a MRI was taken and she was put on neoropathic pain medicine followed by physiotherepy.

The pain did not subside. She is unable to stand on the feet and balance. Once she stands the pain pulls are down and takes hours to subside post hot water bag treatment and cool down.

recently 10 days back we were told by the neurologist that the pain is not from the nerves and were told to do amother MRI and were asked to consult a Orthopedic surgeon. The orthopethdic surgeon put her
on some muscle relaxents and pain killers and she pain is subsided around 60 to 70 % in last 5 to 6 days.


The orthepedic surgeon instepcted her and in order to indentifying what is causing he pain, asked to do bone scan.

Bone scan report was earlier shared with you. When we met orthopedic surgeoon he said the bone scan is picked up some thing that has not been picked up by earlier 2 MRIs and that is highly impossible as their MRI is very sensitive and shoudl pick up the infection etc.

As per him he wants to further analyse the infection (if it is bone TB etc or others) and may have to do biopsy for the same.

We were little concerned by this and hence trying to check if this is the right way to go.

You did mention in earlier response on other Xrays and blood test for detecting infection and treating the same.

Would appreciate if you can guide on the right diagnosis path that has to be taken in this case.

PS: MRI reports enclosed.

Answered by Dr. Krishna Kumar 10 hours later

Thank you for sending me the reports and detailed history of your mother. This made me feel as though I am seeing her.

First of all I am certain, she has no infection; so don’t worry about bone scan and the comments.

I am of the opinion that there can be only two possibilities here:

1. As she is diabetic, it could be a part of diabetic neuropathy/plexopathy which causes severe pain. Medication like what she is currently taking should help her.

2.Next is “neuropathic pain” - due to nerve compression by disc and other degenerative changes as per the MRI reports, for which again medicines/injections and even surgery (if no improvement) may be needed.

The bottom-line is that, “I feel at present she need not undergo any biopsy; and as pain has subsided by 70% in 5 days it is an excellent response to medicines.
So give her 4-8 weeks time for the body to react to the medicines and I sincerely feel that she would come out of this situation considerably well”.

Hope this clarifies your doubts. Please accept my answer if you do not have any further queries.

Best wishes
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