[sjayswal]

#5584

DEAR DOCTOR,
I AM 36 YEAR OLD FEMALE, I AM HAVING SEVERE PAIN IN THE LOWER BACK WHICH EXTENDS TO THE LEFT LEG, THE PAIN IS SO SEVERE THAT I HARDLY CAN MOVE, RECENTLY I MET A DOCTOR FOR THE PROBLEM HE PRESCRIBED MRI THE REPORT OF WHICH IS AS UNDER:-

AP DIAMETER OF SPINAL CANAL AREA

L1-2 1.5 CM
L3-4 1.5 CM
L4-5 0.74 CM
L5-S1 1.0 CM

OPINION:-DIFFUSE ANNULAR BULGE WITH LARGE CENTRAL /LEFT PARA CENTRAL DISC PROTRUSION AT L4-5 LEVEL AND DIFFUSE ANNULAR BULGING AT L5-S1 DISC.

AFTER GOING THROUGH THE MRI REPORT THE DR. HAS ADVISED ME TO UNDERGO IMMEDIATE SURGERY AND UNTIL SURGERY COMPLETE BED REST, I NEED TO ASK DO I REALLY NEED THE SURGERY AND IF YES WHAT IS THE SUCCESS RATE AND WHAT ARE THE RISKS ASSOCIATED WITH THE SURGERY? AND IF I AM NOT WILLING TO UNDERGO THE SURGERY AM I SAFE OR IS THERE ANY CHANCE TO RECOVER WITH ONLY BED REST?

[Donald Corenman, MD, DC]

#5598

The information supplied is incomplete regarding the need for surgery. You most likely have a disc herniation at L4-5 that is compressing the left L5 nerve. That can cause the pain you describe. The indications for surgery are motor weakness, cauda equina syndrome and pain that cannot be tolerated.

If you have no motor weakness (you can walk on your heels keeping your toes on the left side in the air) and you don’t feel like you are going to sprain your ankle (inadvertently turn your ankle in with walking), you most likely do not have motor weakness. However, if you cannot perform the above activities, in my opinion, surgery is necessary.

You do not have cauda equina syndrome (the herniation is not large enough to cause that according to the report). If you have no motor weakness but the pain is severe, surgery can be contemplated. If you want to try to reduce the pain without surgery, you could try an epidural injection and oral medications.

Dr. Corenman

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