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    What does my MRI scan report indicate?

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Posted on Mon, 15 May 2017 in Headache and Migraines
Question: Hello doctor
I am attaching a MRI report. Please would you like to provide advice to what would be the best treatment for this condition.
Surgery or therapy or any other method.

doctor
Answered by Dr. Olsi Taka 56 minutes later
Brief Answer:
Surgery should be considered.

Detailed Answer:
I read your question carefully and I understand your concern.

That MRI report does show diffuse degenerative spinal changes in all levels but mostly in the last two, between L4-L5 and L5-S1 vertebrae. Judging by the MRI both those levels are definitely candidates for surgery. The decision whether to have surgery though depends also on the clinical picture not MRI alone. There are cases with marked changes but minimal symptoms or symptoms soon getting better.

For that reason the first step is always physical therapy and pain killers. Local injections may also mediate a quick relief for some time enabling to better perform physical therapy.

Only if after at least 4-6 weeks of therapy there is no improvement, with marked pain should surgery be done.

There are exceptions when surgery should be done as soon as possible. That would be when there are bladder control issues, muscular weakness, bilateral pain. If that is your case (and it could be seeing there is contact with cauda equina and nerve roots) then surgery should be done sooner rather than later, even on an emergency basis. If symptoms are milder though, say back pain, no bladder or weakness issues it can wait and physical therapy should be tried.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Olsi Taka 1 hour later
What would be the success rate of surgery? Is there any post surgery risk or not?
Which hospital would you recommend for surgery in XXXXXXX Thailand or in Japan.
doctor
Answered by Dr. Olsi Taka 2 hours later
Brief Answer:
Answers as follows

Detailed Answer:
The success rates in relieving pain in lower spine surgery are generally considered between 80-90%. As for post surgery risks, of course any surgical procedure carry some risks, mainly of infection, deep vein thrombosis in the limbs, cerebrospinal fluid leak, nerve root damage. The complication rate is low though, under 3%.

As for hospital recommendations you should keep in mind that as this site involves doctors from all over the world I happen to live and exercise in Europe. As a result I can't say to have had any personal experiences with hospitals from those countries you mention, so perhaps not the best source. I can say that the Apollo hospitals in XXXXXXX have a good reputation. In Japan the University of Tokyo Hospital (though the level in Japan is so high that any center offers a high level). As for Thailand it's hard to say as I have never met any colleague from that country, do not have any idea about the health care and hospitals there.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3654 Questions

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