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What Causes Back Aches?
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 Spondylolysis 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 Spondylolysis 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:
Need further details
Detailed Answer:
Dear Friend.
Welcome to Healthcaremagic.
Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.
There are age related changes in the MRI Report. Also there are disc protrusions.
Decision to do a surgery would depend on many things.
If i just see this report i would not advise surgery until and unless there is a nerve compression, or weakness in legs or wasting in legs.
Answer me following:
1. Is her pain intolerable?
2. Any weakness in legs? Can she walk easily?
3. Any loss of muscle mass of both legs?
4. Any tingling or numbness in legs?
5. Is she overweight?
6. Any diabetes, hypertension?
This is my personal opinion based on details available here. If you still have any other query, you may please ask me and answer these questions preferably in point wise manner.
Stay Healthy.
Dr Anshul Varshney , MD
Need further details
Detailed Answer:
Dear Friend.
Welcome to Healthcaremagic.
Hi , I am Dr Anshul Varshney , I have read your query in detail , I understand your concern.
There are age related changes in the MRI Report. Also there are disc protrusions.
Decision to do a surgery would depend on many things.
If i just see this report i would not advise surgery until and unless there is a nerve compression, or weakness in legs or wasting in legs.
Answer me following:
1. Is her pain intolerable?
2. Any weakness in legs? Can she walk easily?
3. Any loss of muscle mass of both legs?
4. Any tingling or numbness in legs?
5. Is she overweight?
6. Any diabetes, hypertension?
This is my personal opinion based on details available here. If you still have any other query, you may please ask me and answer these questions preferably in point wise manner.
Stay Healthy.
Dr Anshul Varshney , MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. Is her pain intolerable?
>>She gets pain in the morning when she wakes and then when she is standing for 30 minutes at a stretch. The pain is tolerable.
2. Any weakness in legs? Can she walk easily?
>> She walks everyday for 20-30 minutes but after that she feels her legs become heavy and sits down.
3. Any loss of muscle mass of both legs?
>>she did not notice anything
4. Any tingling or numbness in legs?
>>Her legs become heavy after standing for 30 minutes or walking for 20-30 minutes. She has some pain in her left leg and the urgency to pass urine
5. Is she overweight?
>>Yes, she is
6. Any diabetes, hypertension?
She has both diabetes and is hypertensive.
I am also attaching her MRI and x-ray reports. Should this question go to a neurosurgeon?
>>She gets pain in the morning when she wakes and then when she is standing for 30 minutes at a stretch. The pain is tolerable.
2. Any weakness in legs? Can she walk easily?
>> She walks everyday for 20-30 minutes but after that she feels her legs become heavy and sits down.
3. Any loss of muscle mass of both legs?
>>she did not notice anything
4. Any tingling or numbness in legs?
>>Her legs become heavy after standing for 30 minutes or walking for 20-30 minutes. She has some pain in her left leg and the urgency to pass urine
5. Is she overweight?
>>Yes, she is
6. Any diabetes, hypertension?
She has both diabetes and is hypertensive.
I am also attaching her MRI and x-ray reports. Should this question go to a neurosurgeon?
Brief Answer:
Detail Follows
Detailed Answer:
Dear XXXXXXX
Welcome again.
I have not found any reports attached.
However, with the available details, i would suggest conservative management only. That is no surgical intervention required.
I advise following:
1. To get her daily physiotherapy sessions by an expert.
2. To give her Vitamin D3 supplement at least 60,000 unit per week.
3. For pain, she can be started on drugs like Duloxetine which gives relief in pain in long term.
4. She can also be given a combination of Pregabalin and Methylcobalamine.
5. For acute severe pain, she can take Tramadol.
6. Good control of diabetes and hypertension.
7. To promote weight loss.
This is my best opinion for her.
If you have any further query,please ask me.
Stay Healthy
Detail Follows
Detailed Answer:
Dear XXXXXXX
Welcome again.
I have not found any reports attached.
However, with the available details, i would suggest conservative management only. That is no surgical intervention required.
I advise following:
1. To get her daily physiotherapy sessions by an expert.
2. To give her Vitamin D3 supplement at least 60,000 unit per week.
3. For pain, she can be started on drugs like Duloxetine which gives relief in pain in long term.
4. She can also be given a combination of Pregabalin and Methylcobalamine.
5. For acute severe pain, she can take Tramadol.
6. Good control of diabetes and hypertension.
7. To promote weight loss.
This is my best opinion for her.
If you have any further query,please ask me.
Stay Healthy
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Doctor.
I think now the reports have got updated. Please check and let me know.
Thanks!
I think now the reports have got updated. Please check and let me know.
Thanks!
Brief Answer:
Detail Follows.
Detailed Answer:
Dear XXXXXXX
I have seen the reports.
There is same evidence on Xrays as on MRI.
I would suggest you to discuss with your doctor regarding my opinion on treatment.
If he agrees, follow this and revert to me after 1 month with the progress.
If you have any further query please ask me.
Detail Follows.
Detailed Answer:
Dear XXXXXXX
I have seen the reports.
There is same evidence on Xrays as on MRI.
I would suggest you to discuss with your doctor regarding my opinion on treatment.
If he agrees, follow this and revert to me after 1 month with the progress.
If you have any further query please ask me.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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