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Postero Central Inferior Disc Extrusion Causing Severe Secondary Canal Stenosis. Treatment?

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Posted on Thu, 20 Jun 2013
Question: diffuse disc bulge with bilateral paracentral/postero central inferior disc extrusion causing severe secondary canal stenosis/compleate myelogram cut off sign at L5-S1 level compressing the thecal sac/cauda equina nerve roots with narrowing of bilateral neural foramina causing compression over traversing nerve roots at their lateral recessess and indentation over exiting nerve roots at their foraminal levels.Mild facetal arthropathy is also seen at this level. Mild osteoporotic and other degenerative changes as described above
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Answered by Dr. Sudhir Kumar (8 minutes later)
Hi Mr XXXXXXX,

Thank you for posting your query.

I have gone through your mail and MRI reports in detail.
The reports suggest a severe disc prolapse at L5-S1 level (lower back region), with compression of nerve at that level. This nerve travels from lower back to the foot region. As a result, this leads to back pain, which radiates to the thigh, leg, calf and foot. Pain may increase on walking. Associated numbness, tingling and weakness of leg may also occur.

The definitive treatment is surgery, where the pressure on the nerve is released by operation.

In the meanwhile, the following treatments are advised:

1. Bed rest,
2. Medications such as gabapentin or pregabalin, methycobal, and pain killers,
3. Physiotherapy, such as traction, IFT/ultrasound, etc.

I hope it is helpful.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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Postero Central Inferior Disc Extrusion Causing Severe Secondary Canal Stenosis. Treatment?

Hi Mr XXXXXXX,

Thank you for posting your query.

I have gone through your mail and MRI reports in detail.
The reports suggest a severe disc prolapse at L5-S1 level (lower back region), with compression of nerve at that level. This nerve travels from lower back to the foot region. As a result, this leads to back pain, which radiates to the thigh, leg, calf and foot. Pain may increase on walking. Associated numbness, tingling and weakness of leg may also occur.

The definitive treatment is surgery, where the pressure on the nerve is released by operation.

In the meanwhile, the following treatments are advised:

1. Bed rest,
2. Medications such as gabapentin or pregabalin, methycobal, and pain killers,
3. Physiotherapy, such as traction, IFT/ultrasound, etc.

I hope it is helpful.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/