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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Spinal Stenosis

I have L4-5 posterior disc bulge with increasing central spinal stenosis and the AP canal diameter is about 5 mm. I see a neurosurgeon soon. Is this 5mm diameter not good? I also have severe facet arthropathy at this level and a thick walled synovial cyst. I have bulging discs and moderate facet arthropathy at 4 more levels. I am most concerned about the stenosis. What can I expect the surgeon to do?
Fri, 2 Jan 2015
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Radiologist,  's  Response
Hi,
Thanks for writing in.

You seem to be having a significant spinal canal stenosis. There is a passage in the spine running the neck to the lower back through which the spinal cord passes. In the lower back the spinal cord but the nerves continue to exit through small foramina on both sides of the spine. Disc bulges cause narrowing of the canal and pinching of the nerves leading to severe lower back pain. A spinal canal dimension of 5 mm in AP direction is small and can be the cause for significant pain and discomfort. A visit to the neurosurgeon will help in knowing the amount of discomfort you are in and if surgical correction of the bulging disc at L 4 - L 5 level will improve your pain.
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Suggest Treatment For Spinal Stenosis

Hi, Thanks for writing in. You seem to be having a significant spinal canal stenosis. There is a passage in the spine running the neck to the lower back through which the spinal cord passes. In the lower back the spinal cord but the nerves continue to exit through small foramina on both sides of the spine. Disc bulges cause narrowing of the canal and pinching of the nerves leading to severe lower back pain. A spinal canal dimension of 5 mm in AP direction is small and can be the cause for significant pain and discomfort. A visit to the neurosurgeon will help in knowing the amount of discomfort you are in and if surgical correction of the bulging disc at L 4 - L 5 level will improve your pain.