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Underwent MRI for back pain. Have spinal canal stenosis. Evaluate and does it require surgery?

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Orthopaedic Surgeon
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My mom underwent MRI as recommanded by orthopaedic surgeon as we went for back pain from a year..for which used to take pain killer tab and physiotherapy in between.last week she did MRI ...and the reports says
L4L5 disc herniation with secondary spinal canal stenosis by thickening of ligament um she requires decompression and screws n rod fixing surgery.her pain scale is only between 5-6,does normal daily I need your valuable opinion about the condition and surgery
Posted Sat, 6 Jul 2013 in Back Pain
Answered by Dr. Praveen Tayal 2 hours later
Thanks for posting your query.
Your mother is having a disc prolapse with stenosis of the foramina from which nerves come out causing the nerve compression.
Right now she has got only one symptom- pain of moderate intensity.
The treatment is done according to the severity of symptoms. Medicines are the first line treatment along with physiotherapy. If the patient responds well with medicines then physiotherapy helps in preventing further progression of the problem. Surgery is kept as a last resort to improve the quality of life of the patient.
Signs of worsening of symptoms are- pain causing disability, numbness, weakness, loss of urinary or bowel control.

When the symptoms get worse, kindly visit a Spine surgeon to consider surgical treatment. Right now a surgical treatment is not required.

The main treatment of such problem is bed rest along with pain killers and muscle relaxants. Muscle relaxants can help with her symptoms if used in appropriate dosage in combination with a potent analgesic. You can get these prescribed from her orthopedician.
Local analgesic gels and hot fomentation may provide a short term relief. She can use analgesic gels like Volini gel. Exercise is not advisable in the times of acute pain.
Using an LS contour belt of appropriate size might be helpful in providing support to back muscles.
Physiotherapy also plays a major role in treating such conditions. Epidural steroid injections have been used if oral pain killers are not very effective and surgical treatment is not considered. Discuss with your orthopedician and an appropriate treatment can be planned depending on the response to medical drugs.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Underwent MRI for back pain. Have spinal canal stenosis. Evaluate and does it require surgery? 21 hours later
Dr I have attached MRI in this we r scared that her spinal canal is occupied nearly 75%
But there z no neurological problems as such expect pain.dr told c z prone to cords sequins syndrome at any time .
Its corda equina syndrome . .as said by dr .
Answered by Dr. Praveen Tayal 1 hour later
Thanks for writing again.
I have seen the MRI images attached. There seems to be a mild compression of the nerve roots only. Cauda equina syndrome is characterized by acute severe pain, loss of bowel and bladder control, muscle weakness, etc.
You can take a second opinion from a neurologist to assess the severity of the problem clinically. A surgery is not recommended in case of mild symptoms like your mother's.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
Follow-up: Underwent MRI for back pain. Have spinal canal stenosis. Evaluate and does it require surgery? 20 minutes later
Thank u sir
Answered by Dr. Praveen Tayal 1 hour later
Thank you.
I am glad I could help.
You can consult me again directly through my profile URL
Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.
I wish you the very best in whatever you do.
Warm regards
Above answer was peer-reviewed by
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