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What Does This MRI Report Indicate?
Question: My mother is 58 years old and she is suffering a lot of pain in her back and legs with numbness, especially the left leg from her hips all the way to the ankle and toes from the side of the left leg due to loss of lumbar lordosis and spine issues. See attach MRI reports.
In addition, she has another illness and condition such, Blood pressure, diabetes type 2 and lack of sleeping; also, she had four times catheterization and balloon angioplasty. See the attach file.
Recently, we have visited five doctors in our city SULAIMANIYAH and all of them recommended the lone treatment is surgery to crack the bones and give some extra space to reduce the pressure on the nerves.
For 10 days and currently, she is receiving physical therapy sessions, like exercise and using frequency to reducing pain. The severe pain is little away, but still, she suffers continual pain on her legs and back also including feeling weighty leg.
We would like to be advised by a doctor or specialist in spine, disk, and nerves that what is the essential treatment?
What we would like to know:
• What is the vital treatment?
• Does the surgery be the solo treatment for my mother s’ condition?
• Is there any chance for avoiding surgery?
• What is the surgical procedure for her?
• How long the duration of the surgery?
• What is the chance of the successful surgery?
• What type of doctor will make the surgery? Neurosurgery or neurologist?
• What kind of medical test must we do before surgery?
• What more test we must have and know?
• What are the worst-case scenarios? What If we face the worst case?
She takes the following medication for Blood pressure, diabetes type 2, high cholesterol, also the attach files regarding the medication, she takes for the current condition, which all of them are pain killers.
• Kombiglyze XR 2.5 mg/1000 mg Modified release Saxagliptin; Metformin hydrochloride. She takes this pill two times a day, Morning and evening.
• Metformin HCL Aurobindo 850 mg. She takes this pill two times a day, Morning and evening.
• AMARYL 3MG GLIMEPIRIDE. She takes this pill one time a day.
Also, she takes the following medication too for other issues such:
• Roxardio 20mg rosuvastatin calcium. She takes this for cholesterol once a day.
• B-Cor 5 bisoprolol fumarate 5mg - She takes this for high blood pressure, twice a day.
• Aspirin. Once a day.
• Rabelis for stomach aches due to pills once a day.
Thank you in advance.
In addition, she has another illness and condition such, Blood pressure, diabetes type 2 and lack of sleeping; also, she had four times catheterization and balloon angioplasty. See the attach file.
Recently, we have visited five doctors in our city SULAIMANIYAH and all of them recommended the lone treatment is surgery to crack the bones and give some extra space to reduce the pressure on the nerves.
For 10 days and currently, she is receiving physical therapy sessions, like exercise and using frequency to reducing pain. The severe pain is little away, but still, she suffers continual pain on her legs and back also including feeling weighty leg.
We would like to be advised by a doctor or specialist in spine, disk, and nerves that what is the essential treatment?
What we would like to know:
• What is the vital treatment?
• Does the surgery be the solo treatment for my mother s’ condition?
• Is there any chance for avoiding surgery?
• What is the surgical procedure for her?
• How long the duration of the surgery?
• What is the chance of the successful surgery?
• What type of doctor will make the surgery? Neurosurgery or neurologist?
• What kind of medical test must we do before surgery?
• What more test we must have and know?
• What are the worst-case scenarios? What If we face the worst case?
She takes the following medication for Blood pressure, diabetes type 2, high cholesterol, also the attach files regarding the medication, she takes for the current condition, which all of them are pain killers.
• Kombiglyze XR 2.5 mg/1000 mg Modified release Saxagliptin; Metformin hydrochloride. She takes this pill two times a day, Morning and evening.
• Metformin HCL Aurobindo 850 mg. She takes this pill two times a day, Morning and evening.
• AMARYL 3MG GLIMEPIRIDE. She takes this pill one time a day.
Also, she takes the following medication too for other issues such:
• Roxardio 20mg rosuvastatin calcium. She takes this for cholesterol once a day.
• B-Cor 5 bisoprolol fumarate 5mg - She takes this for high blood pressure, twice a day.
• Aspirin. Once a day.
• Rabelis for stomach aches due to pills once a day.
Thank you in advance.
Brief Answer:
The answers to your questions as follows.
Detailed Answer:
I read your question carefully and I understand your concern.
All the treatment for spinal stenosis is aimed at relieving symptoms, so if by vital treatment you mean curative, there isn't such a treatment. There are conservative and surgical approaches.
Usually conservative approach is always tried first, at least for a few months (exceptions being severe weakness of the limbs and bladder control issues - those need urgent surgery).
Mainstay of surgical approach is physical therapy and steroid injection. Since she has had only 10 days of physical therapy I would give it some more time, at least 6 weeks. Other modalities are traction therapy, table inversion therapy (but not that safe in people with heart issues, wouldn't advise), chiropractics, TENS therapy. Efficacy of these other alternatives is limited though, provide relief oly in a minority of patients.
Otherwise the remaining alternative is surgery. So there is a chance to avoid surgery, but if physical therapy and steroid injections fails there is not much choice. The decision on whether to do it or not is guided by severity of symptoms, if as you say pain is severe and disabling surgery is advised.
The most common surgical procedure is laminectomy, removing the lamina, a part of the vertebra to relieve pressure.
Duration of surgery is tough to say, depends also on the individual surgeon, not all surgeons work with the same speed, some work more quickly than others (not necessarily better). There is also the time of anesthesia, preparation and positioning for surgery. On the whole usually it is about 2-3 hours, but as I said varies between individual physicians.
Chances of a successful surgery are at about 70-80%. As the name suggests naturally it is done by neurosurgeons, neurologists do not perform surgery. In some clinics there may be found also orthopedic surgeons specialized in spine surgery.
Main test to be done is the MRI which has already been done. If the surgeon is unsure about the level suffering most, at times nerve conduction studies may be done as well (but not routinely). Of course repeat of routine blood tests, re-evaluation of her other conditions will be required before surgery.
From a neurological point of view the worst case scenario is simply surgery not working, there is a percentage of patients in which symptoms persist. Other risks are risks which apply to any type of surgery such as wound infection, deep vein thrombosis and pulmonary embolism (low risk) and risks of any patient undergoing general anesthesia (heart attack, pneumonia, allergic reactions etc).
I remain at your disposal for other questions.
The answers to your questions as follows.
Detailed Answer:
I read your question carefully and I understand your concern.
All the treatment for spinal stenosis is aimed at relieving symptoms, so if by vital treatment you mean curative, there isn't such a treatment. There are conservative and surgical approaches.
Usually conservative approach is always tried first, at least for a few months (exceptions being severe weakness of the limbs and bladder control issues - those need urgent surgery).
Mainstay of surgical approach is physical therapy and steroid injection. Since she has had only 10 days of physical therapy I would give it some more time, at least 6 weeks. Other modalities are traction therapy, table inversion therapy (but not that safe in people with heart issues, wouldn't advise), chiropractics, TENS therapy. Efficacy of these other alternatives is limited though, provide relief oly in a minority of patients.
Otherwise the remaining alternative is surgery. So there is a chance to avoid surgery, but if physical therapy and steroid injections fails there is not much choice. The decision on whether to do it or not is guided by severity of symptoms, if as you say pain is severe and disabling surgery is advised.
The most common surgical procedure is laminectomy, removing the lamina, a part of the vertebra to relieve pressure.
Duration of surgery is tough to say, depends also on the individual surgeon, not all surgeons work with the same speed, some work more quickly than others (not necessarily better). There is also the time of anesthesia, preparation and positioning for surgery. On the whole usually it is about 2-3 hours, but as I said varies between individual physicians.
Chances of a successful surgery are at about 70-80%. As the name suggests naturally it is done by neurosurgeons, neurologists do not perform surgery. In some clinics there may be found also orthopedic surgeons specialized in spine surgery.
Main test to be done is the MRI which has already been done. If the surgeon is unsure about the level suffering most, at times nerve conduction studies may be done as well (but not routinely). Of course repeat of routine blood tests, re-evaluation of her other conditions will be required before surgery.
From a neurological point of view the worst case scenario is simply surgery not working, there is a percentage of patients in which symptoms persist. Other risks are risks which apply to any type of surgery such as wound infection, deep vein thrombosis and pulmonary embolism (low risk) and risks of any patient undergoing general anesthesia (heart attack, pneumonia, allergic reactions etc).
I remain at your disposal for other questions.
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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