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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain In The Back Due Disc Herniation. Diffuse Disc Bulge. Surgery Necessary?

Dear doctor:
I had a pain in my back about fifteen or more years ago . radiologists said I had disc herniation. Ididn't care about it until now. about a year ago. Ifelt a bad pain in my left leg.I WASN.T ABLE TO WALK PROPERLY.i had to rest for a while to be able to walk again. I VISITED a doctor .He prescribed two ampules called,Dexonett and Neurobion .
I take Lyrica capsule every night, I FEEL MUCH BETTER. my doctor ordred me to have an MRI test.the MRI shows"Lumbar vertebrae demostrated normal height,shape and configuration.
Disc desiccation is noted at level of L4-L5 and L5-S1.ATthe level of L5-S1 DIFFUSE DISC BULGING WITH GRADE 1 ANTERIOR LISTHESIS ASSOCITED WITH FACET joint hypertrphy causing pressure ever excistingnerve roots bilatherally.
At the level L4-L5 DIFFUDE DISC BULGING WITH SMALL CENTRAL AND RIGHT PARACENTRAL disc protrusion causing pressure over existing nerve roots predominantly on the right side.
Type ii subchondoral modic change is seen at level L5-S1.Conus medullaris is normal in location, internal signal intensity,shape and devision to its filaments.
Pre and para vertebral soft tissue structures are unremarkable.
Would you please help me what to do> DO YOU THINK IT IS NECESSARY TO HAVE A SURGERY?

YOUR AFFECTIONATELY
ADISH
Wed, 22 May 2013
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Neurologist 's  Response
Hi Mr Adish,
Thank you for posting your query.
The symptoms and MRI report are suggestive of severe compression of nerves at the lower back due to disc herniation.
Surgery is the best treatment to relieve nerve compression, leading to reduction in pain. So, surgery would definitely be beneficial. However, prior to surgery, you could try bed rest, physiotherapy and medications for 3-4 weeks. If they work, you can avoid surgery, or otherwise, you can go for surgery.
Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My email: drsudhirkumar@yahoo.com
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Pain In The Back Due Disc Herniation. Diffuse Disc Bulge. Surgery Necessary?

Hi Mr Adish, Thank you for posting your query. The symptoms and MRI report are suggestive of severe compression of nerves at the lower back due to disc herniation. Surgery is the best treatment to relieve nerve compression, leading to reduction in pain. So, surgery would definitely be beneficial. However, prior to surgery, you could try bed rest, physiotherapy and medications for 3-4 weeks. If they work, you can avoid surgery, or otherwise, you can go for surgery. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar My email: drsudhirkumar@yahoo.com