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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ruptured Disc Pressing Against Nerve. Advised Surgery. Possibility Of Permanent Nerve Damage During Surgery?

I AM A 53 YEAR OLD MALE WITH RUPTURED DISC THAT STARTED 2 YEARS AGO. I HAVE BEEN ABLE TO LIVE WITH THE BACK PAIN AND MOST OF THE TIME IT SUBSIDES. I HAVE HAD TIMES WHEN IT CONTINUED DOWN MY LEG WITH MORE PAIN.THE MRI SHOWS A PIECE OF DISC BROKEN LOOSE THAT CAN PRESS AGAINST A NERVE AND DOCTOR HAS SUGGESTED SURGERY WHEN THE PAIN GETS OUT OF CONTROL. DOCTOR SAYS ITS SIMPLE PROCEDURE TO REMOVE PIECE. MY QUESTION IS WHAT ARE THE RISK THAT THEIR COULD BE FOR PERMENENT DAMAGE BY CUTTING A NERVE DURING PROCEDURE. IS IT MORE DANGEROUS ALSO TO WAIT FOR SURGERY. I HERD THAT WAITING SOMETIMES CAUSES PERMANENT DAMAGE. THE PAIN HAS STAYED WITH ME THIS TIME ABOUT 6 WEEKS AND IT SOMETIMES UNBEARABLE IN MY LEG.NEED SOMETHING DONE SO I CAN CONTINUE TO WORK.
Sat, 30 Mar 2013
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Neurologist 's  Response
Hi,

Thanks for the query,


Before I respond to your questions, let me tell you that the management of disc problem whether medical or surgical depends upon the clinical and investigations findings. It should never be based upon the MRI findings. If a patient has pain and neurological deficit (documented by a neurologist) and pain has not responded to medical management and MRI shows problem with clinical correlation, then surgery is the best option. How ever, if a patient has pain alone and there are no other neurological deficits, initial treatment should always be conservative with medicines and physiotherapy. Persistent pain despite treatment is another indications for surgery.

If you feel that you have tried medications and physical therapy and the pain still continues you may opt for surgery the way your doctor has advised. I agree with your doctor in the sense that this will not result in any permanent damage of the nerve. You may even wait if you do not have any other symptoms except pain. Waiting will not cause permanent damage to the nerves in this type of situations.

Hope this clarifies
Best wishes
Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy)
Consultant Neurologist and Epilepsy specialist
Nrayana Hrudayalaya Hospital, Bangalore
My Blog in the Web site:
http://www.healthcaremagic.com/doctors/dr-gopal-krishna-dash/64344

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Ruptured Disc Pressing Against Nerve. Advised Surgery. Possibility Of Permanent Nerve Damage During Surgery?

Hi, Thanks for the query, Before I respond to your questions, let me tell you that the management of disc problem whether medical or surgical depends upon the clinical and investigations findings. It should never be based upon the MRI findings. If a patient has pain and neurological deficit (documented by a neurologist) and pain has not responded to medical management and MRI shows problem with clinical correlation, then surgery is the best option. How ever, if a patient has pain alone and there are no other neurological deficits, initial treatment should always be conservative with medicines and physiotherapy. Persistent pain despite treatment is another indications for surgery. If you feel that you have tried medications and physical therapy and the pain still continues you may opt for surgery the way your doctor has advised. I agree with your doctor in the sense that this will not result in any permanent damage of the nerve. You may even wait if you do not have any other symptoms except pain. Waiting will not cause permanent damage to the nerves in this type of situations. Hope this clarifies Best wishes Dr Gopal K Dash MD, DM, Post-doctoral fellowship (Epilepsy) Consultant Neurologist and Epilepsy specialist Nrayana Hrudayalaya Hospital, Bangalore My Blog in the Web site: http://www.healthcaremagic.com/doctors/dr-gopal-krishna-dash/64344