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Suggest Treatment For Prolonged Back Ache
Question: My mom is 69 years old and has been having back ache for the last 30 years.
I finally took her to a doc and he asked for a scan. The result is as below. Please help me as what should be her next steps. She is very scared of surgery.
IMPRESSION
MRI of LUMBOSACRAL Spine shows
1.Lumbar Spondylosis with Modic Type III changes multiple vertebrae.
2. Bilateral Spondylolysis L5 with grade I forward Listhesis of L5 over S1.
3. Small posterior central disc bulge seen at L3-L4 and L4-L5 with mild impression on the thecal sac. No obvious nerve root compression.
4. Diffusely bulging disc seen at L5-S1 with mild impression on the thecal sac and both exiting nerve roots.
5. Whole spine screening shows spondylotic changes with disc Osteophyte complex at c5-c6 and c6-c7 with compressive myelopathy cord from c5 to c6-c7 level.
6. Empty Sella - Incidental finding.
I finally took her to a doc and he asked for a scan. The result is as below. Please help me as what should be her next steps. She is very scared of surgery.
IMPRESSION
MRI of LUMBOSACRAL Spine shows
1.Lumbar Spondylosis with Modic Type III changes multiple vertebrae.
2. Bilateral Spondylolysis L5 with grade I forward Listhesis of L5 over S1.
3. Small posterior central disc bulge seen at L3-L4 and L4-L5 with mild impression on the thecal sac. No obvious nerve root compression.
4. Diffusely bulging disc seen at L5-S1 with mild impression on the thecal sac and both exiting nerve roots.
5. Whole spine screening shows spondylotic changes with disc Osteophyte complex at c5-c6 and c6-c7 with compressive myelopathy cord from c5 to c6-c7 level.
6. Empty Sella - Incidental finding.
Brief Answer:
Surgery is not needed now.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted your mother's X-rays and MRI reports. I also saw the pictures of scan attached here.
I would like to reassure you that the abnormalities are mild-moderate in severity and surgery is not needed at present.
As of now the treatment would consist of following:
1. Medications such as pregabalin or gabapentin- this would help in relieving the nerve-related pain.
2. Vitamin B12 supplements for nerve regeneration.
3. Use of neck collar and lumbo-sacral belt. This should be used definitely while travelling.
4. Physiotherapy- with IFT/ultrasound and traction. After pain is reduced, neck and back extension exercises should be started.
5. She should avoid forward bending and lifting heavy weights.
This treatment should be continued for 4-6 weeks to see the desired benefits.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Surgery is not needed now.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted your mother's X-rays and MRI reports. I also saw the pictures of scan attached here.
I would like to reassure you that the abnormalities are mild-moderate in severity and surgery is not needed at present.
As of now the treatment would consist of following:
1. Medications such as pregabalin or gabapentin- this would help in relieving the nerve-related pain.
2. Vitamin B12 supplements for nerve regeneration.
3. Use of neck collar and lumbo-sacral belt. This should be used definitely while travelling.
4. Physiotherapy- with IFT/ultrasound and traction. After pain is reduced, neck and back extension exercises should be started.
5. She should avoid forward bending and lifting heavy weights.
This treatment should be continued for 4-6 weeks to see the desired benefits.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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