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Osteoporosis. Having Back Pain, Swollen Foot And Walking Difficulty. Should I Go For Surgery?

Posted on Wed, 20 Mar 2013

Question: My mother-in-;aw has sever back pain (left side) and she walks with great difficulty
- She has swelling on her left feet. We took her to a doctor who advised many tests.
Following is summary of ultrasound and MRI
Ultrasound
---------------------

right renal interpolar 11.4 m
upper polar 7.4 m
calculus with mild hydronefrosis

MRI
-------
grade 1 anterior spodylosis noted at L4 5 level
with bilateral spondylosis
moderate dis dessication at lumbar levels
mild diffuse annular bulge at all other levels

Other tests
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HbA1C : 7.2 (RBSand FBS was normal)
creatinine : 1.3

She had high BP recently 190/100

Doctor has prescribed the following medicine
------------------------------------------------------------------

- concor am 5 (blood pressure )
- pantacid
- ultracet tab
- calcium tablet

and said that she needs to go for a surgery if the pain does not subside.
It is about a week and pain has not gone down so we went to another doctor a GP yesterday who prescribed.

- concor am 5
- pantacid
- freeflex
- DOLOMAX DT
- Aldofti
- torxyvon

She says feels better now. So we are confused as to whether it is necessary to do the surgery?

I remember my father had a spine compression and doctor adviced us to take RENERVE plus and he felt better after a week. I did not see similar medicine in her case.

Please advice as to the course of action we need to take.
We are also worried that since she has osteoporosis, the surgery may not be successful.

Answered by Dr. S K Mishra (10 hours later)

Hi XXXXXXX
Your mother-in-law has many problems,
-sever back pain (left side) and walks with great difficulty
- swelling on her left feet.
-BP recently 190/100
MRI- grade 1 anterior spondylosis noted at L4 5 level
Ultrasound-right renal interpolar 11.4 m, upper polar 7.4 m, calculus with mild hydronephrosis

1. She needs a urologist consultation and probably IVU(intravenous urogram) to exactly see how much renal stones are and need for their treatment.

2.She needs consultation of spine surgeon too. Gr 1 is it spondylolisthesis? i.e. slippage of one vertebra over other. In that case, your mother in law should use lumbar coarset, and then follow advice of spine surgeon examining the patient. However, spondylolisthesis often requires surgery.

3.BP has to be controlled in any case be regular with your physician.
See your mothers in law problems are many so you have to consult more than one specialist as I mentioned. Hope I was able to answer your query.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. S K Mishra (5 hours later)

Hi Dr,

Thanks for your kind answer.

Can you also please tell me whether the operation can be done even if she has osteoporosis? What are the problems?

Thanks and regards
XXXXXXX

Answered by Dr. S K Mishra (44 minutes later)

The patient has to be assessed completely - risks versus benefit has to be evaluated. Yes there is increased difficulty with instrumentation in osteoporosis. In such cases it is difficult to give radical answers. The best judgement is based upon the experience of treating surgeon as well as risk-benefit analysis. There are some school of thoughts who practice decompressive laminectomy without instrumentation. Some patients even live tolerating pain with brace, but again many pain killers may damage kidney.

So in such a difficult situation the best judge again is treating spine surgeon. Also remember listhesis is different condition than mild compression and usually surgery is needed. You discuss things in detail with doctor who is going to perform surgery.

Hope I answered your query.

Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad