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Is Surgery Recommended For A Focal Compression Of Nerve Root Of Marked Spinal Stenosis?
Question: For a focal compression of nerve root of marked spinal stenosis,
Would surgery be recommended?
Would surgery be recommended?
Brief Answer:
I wouldn't recommend surgery.
Detailed Answer:
I read your query and I understand your concern. Since from what I read on other queries you have made, you are under a lot of pain and limited in your movement.
The question though is whether there is a focal compression of nerve root of marked spinal stenosis at a level on which surgery could be applied.
Looking at your imaging reports there are degenerative changes in your lumbar spine at many levels but they are diffuse, there isn't an individual level with marked compression for which the surgery would be of much benefit. The report is pretty careful to specify that.
For that reason, I don't believe surgery is recommended. I recommend to continue with the measures you mention. I see you have already tried non steroid antiinflammatory drugs like Ibuprofen, glucosamine. For chronic pain also the use of antidepressives like amitriptyline or nortriptyline could be useful.
Local injections with corticosteroids and analgesics might also be tried if medication only is not enough.
I remain at your disposal for further questions.
I wouldn't recommend surgery.
Detailed Answer:
I read your query and I understand your concern. Since from what I read on other queries you have made, you are under a lot of pain and limited in your movement.
The question though is whether there is a focal compression of nerve root of marked spinal stenosis at a level on which surgery could be applied.
Looking at your imaging reports there are degenerative changes in your lumbar spine at many levels but they are diffuse, there isn't an individual level with marked compression for which the surgery would be of much benefit. The report is pretty careful to specify that.
For that reason, I don't believe surgery is recommended. I recommend to continue with the measures you mention. I see you have already tried non steroid antiinflammatory drugs like Ibuprofen, glucosamine. For chronic pain also the use of antidepressives like amitriptyline or nortriptyline could be useful.
Local injections with corticosteroids and analgesics might also be tried if medication only is not enough.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
L5 S1 has severe disc narrowing. This can't be corrected?
I have taken wellbutrin in the past. Too many side effects.
Epidural is tomorrow. I will ask the anesthesiologist if there is a corticosteroid in it.
Pain is in my lower back, hip, thigh and knee.
I have diffculty lifting my LT leg.
Decompression therapy is available here, but costly.
I have taken wellbutrin in the past. Too many side effects.
Epidural is tomorrow. I will ask the anesthesiologist if there is a corticosteroid in it.
Pain is in my lower back, hip, thigh and knee.
I have diffculty lifting my LT leg.
Decompression therapy is available here, but costly.
Brief Answer:
No nerve compression though, wouldn't advise surgery.
Detailed Answer:
Surgery for your symptoms usually is considered if there is nerve root compression and the MRI report stresses the fact that there is no obvious impingement of the nerve roots.
You mention Wellbutrin, but while it is an antidepressant, it has not been tried and is not recommended for pain treatment so its lack of success doesn't mean much. Amitriptyline or Nortriptyline meanwhile have been shown to be effective.
Of course they could cause side effects as well and are not always effective, but since you have already tried other medication options, if nothing else succeeds it should be tried.
Surgery at times is tried for severe disc narrowing if it is thought to the lone responsible of your symptoms. It would consist in spinal fusion, by putting a bone graft between vertebral bodies. But apart from it being only as a really last resort, success rate varies and because mobility in that level is lost it increases stress on other joints between other vertebrae. In your case where there are degenerative changes to the other levels as well that might accelerate damage to other discs and joints which could cause more pain. So it's preferred only as a reluctant last resort.
I hope the injection tomorrow will be of help.
No nerve compression though, wouldn't advise surgery.
Detailed Answer:
Surgery for your symptoms usually is considered if there is nerve root compression and the MRI report stresses the fact that there is no obvious impingement of the nerve roots.
You mention Wellbutrin, but while it is an antidepressant, it has not been tried and is not recommended for pain treatment so its lack of success doesn't mean much. Amitriptyline or Nortriptyline meanwhile have been shown to be effective.
Of course they could cause side effects as well and are not always effective, but since you have already tried other medication options, if nothing else succeeds it should be tried.
Surgery at times is tried for severe disc narrowing if it is thought to the lone responsible of your symptoms. It would consist in spinal fusion, by putting a bone graft between vertebral bodies. But apart from it being only as a really last resort, success rate varies and because mobility in that level is lost it increases stress on other joints between other vertebrae. In your case where there are degenerative changes to the other levels as well that might accelerate damage to other discs and joints which could cause more pain. So it's preferred only as a reluctant last resort.
I hope the injection tomorrow will be of help.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
potential for success with decompression therapy?
other options to correct whats going on?
recommended activities?
using sad light. hot tub. swimming.
0h also...are u able to see other posted questions and answers to other doctors?
advisability of carrying a 20 lb baby upstairs, while babysitting?
other options to correct whats going on?
recommended activities?
using sad light. hot tub. swimming.
0h also...are u able to see other posted questions and answers to other doctors?
advisability of carrying a 20 lb baby upstairs, while babysitting?
Brief Answer:
Read below
Detailed Answer:
Success rate for decompression therapy is difficult to put in numbers. There are many studies, some showing improvement in 68% of the cases. However in medicine for studies to be taken as evidence it is preferred to have comparisons between the group having therapy and a control group having other treatments like physiotherapy. Such studies are very few for decompression therapy and those few have not shown much superiority towards other measures.
If I were to answer by personal experience I have had a couple of patients (as well as the mother of a fellow neurologist) who weren't responding to any treatment but responded very well to decompression therapy. So I do recommend it, not as the first step but when physio and medication fails.
Regarding other options from what you have listed it seems you have tried about everything else.
As for activities, swimming and other water activities are beneficial, along with stretching, posture and lower back strengthening exercises, possibly under the guidance of a physiotherapist.
They must not put extra weight on your spine though, so carrying a 20lb baby upstairs is not beneficial.
Yes, I can see what previous questions you have made. It is a useful feature allowing us to see other medical issues you might have, or signs and symptoms you might have not reported (in your case I would have asked you to say some more about the symptoms if I hadn't read something more from previous exchanges).
I hope to have been of help.
Read below
Detailed Answer:
Success rate for decompression therapy is difficult to put in numbers. There are many studies, some showing improvement in 68% of the cases. However in medicine for studies to be taken as evidence it is preferred to have comparisons between the group having therapy and a control group having other treatments like physiotherapy. Such studies are very few for decompression therapy and those few have not shown much superiority towards other measures.
If I were to answer by personal experience I have had a couple of patients (as well as the mother of a fellow neurologist) who weren't responding to any treatment but responded very well to decompression therapy. So I do recommend it, not as the first step but when physio and medication fails.
Regarding other options from what you have listed it seems you have tried about everything else.
As for activities, swimming and other water activities are beneficial, along with stretching, posture and lower back strengthening exercises, possibly under the guidance of a physiotherapist.
They must not put extra weight on your spine though, so carrying a 20lb baby upstairs is not beneficial.
Yes, I can see what previous questions you have made. It is a useful feature allowing us to see other medical issues you might have, or signs and symptoms you might have not reported (in your case I would have asked you to say some more about the symptoms if I hadn't read something more from previous exchanges).
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Prasad
Thank you. It is helpful that you can see the other questions and answers, because as far as I can tell, it isn't possible to follow up with the same physician after the discussion is closed, therefore it would involve quite a bit of repetition to type the whole story again.
Your answers give me a good idea of what to expect when I see the neurosurgeon here. There are long wait times to get an appointment. I have some exercises from physio and am picking up more from youtube. Also looking into using an inversion table.
Although know that i know that the questions and answers are visible, I should be able to send a question to the same doctor. I ask this question to the 'help' people at this site, and they actually told me the opposite......that they were not visible.
Yes you have been very helpful. I will review your responses again as time goes on.
Your answers give me a good idea of what to expect when I see the neurosurgeon here. There are long wait times to get an appointment. I have some exercises from physio and am picking up more from youtube. Also looking into using an inversion table.
Although know that i know that the questions and answers are visible, I should be able to send a question to the same doctor. I ask this question to the 'help' people at this site, and they actually told me the opposite......that they were not visible.
Yes you have been very helpful. I will review your responses again as time goes on.
Brief Answer:
Can use search function to find the doctor you want.
Detailed Answer:
If you want to ask a specific doctor I believe you can search his name (search box in upper right corner). If found there you click to go to his/her profile and then click on "Ask me a question" tab.
Might be other ways, haven't payed much thought really, but that is the easiest way which comes to mind.
Thank you for the kind words. Keep up with the exercises. I hope you will get better soon.
Can use search function to find the doctor you want.
Detailed Answer:
If you want to ask a specific doctor I believe you can search his name (search box in upper right corner). If found there you click to go to his/her profile and then click on "Ask me a question" tab.
Might be other ways, haven't payed much thought really, but that is the easiest way which comes to mind.
Thank you for the kind words. Keep up with the exercises. I hope you will get better soon.
Above answer was peer-reviewed by :
Dr. Prasad
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