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Is Key-hole Surgery Necessary For Chronic Back Pain?
Posted on
Tue, 3 Jun 2014
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 3 Jun 2014
Answered on
Fri, 20 Jun 2014
Last reviewed on
Question : Hi,my mom is 58 yrs old with chronic back pain.but off late she has been experiencing severe pain in the right leg and numbness and cannot stand still for even a minute.her MRI reads...mild articular process hyper trophy at L3-4 and L4-5....L3-4 bulge with thecal compromises,coupled with ligamenta flavum/facet joint capsular hyper trophy causing thecal bilateral L5/L4 neural compromises.L5/S1 disc annular bulge with superadded broad based eccentric herniation/cephalad extrusion causing thecal bilateral S1 (right side more than left)and L5 neural compromises..she has been advised key-hole surgery..is it really necessary?
Brief Answer:
YES,SURGERY IS NECESSARY & IS THE ONLY ANSWER.
Detailed Answer:
Hi,
History of severe pain in (R) leg associated with numbness itself points towards neurological origin of pain.
Articular process hypertrophy with facet joint capsular hypertrophy and arthritis are a part of spondylitic changes which was the cause of chronic backache which your mom suffered from quite sometime. But this is not the cause of severe pain and numbness.
Severe pain in the right leg and numbness is secondary to
1) L 3-4 IVDP with thecal compromise
2) B/L L4-L5 neural compromise
3) L5-S1 IVDP with L5-S1 neural compromise which is (R) > (L) ( this is the reason for the pain being more on the right side.
TREATMENT:
Since there is a significant neural compromise at L4-5 and L5-S1 which is the main cause of pain , it needs to be decompressed and the nerve root needs to be freed for the pain to be relieved which can be done only by SURGERY.
SURGERY: L5-S1 DISCECTOMY (with laminectomy) with B/L root decompression
L4-L5 B/L root decompression
This can be done through KEY HOLE SURGERY.
Nevertheless, SURGERY IS THE RIGHT OPTION without which she wil not be relieved off her pain (since the neural compromise cannot be relieved non surgically)
HENCE , THE ANSWER IS SURGERY.
YES,SURGERY IS NECESSARY & IS THE ONLY ANSWER.
Detailed Answer:
Hi,
History of severe pain in (R) leg associated with numbness itself points towards neurological origin of pain.
Articular process hypertrophy with facet joint capsular hypertrophy and arthritis are a part of spondylitic changes which was the cause of chronic backache which your mom suffered from quite sometime. But this is not the cause of severe pain and numbness.
Severe pain in the right leg and numbness is secondary to
1) L 3-4 IVDP with thecal compromise
2) B/L L4-L5 neural compromise
3) L5-S1 IVDP with L5-S1 neural compromise which is (R) > (L) ( this is the reason for the pain being more on the right side.
TREATMENT:
Since there is a significant neural compromise at L4-5 and L5-S1 which is the main cause of pain , it needs to be decompressed and the nerve root needs to be freed for the pain to be relieved which can be done only by SURGERY.
SURGERY: L5-S1 DISCECTOMY (with laminectomy) with B/L root decompression
L4-L5 B/L root decompression
This can be done through KEY HOLE SURGERY.
Nevertheless, SURGERY IS THE RIGHT OPTION without which she wil not be relieved off her pain (since the neural compromise cannot be relieved non surgically)
HENCE , THE ANSWER IS SURGERY.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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