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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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MRI Scan Shows Mechanical Left Recess Stenosis Due To Disc Extrusion, Disc Bulge. Suggestions?

I have just had an mri scan which i would appreciate your help understanding mechanical left lateral recess stenosis due to left paracentral disc extrusion at L5 S1 with impingement of the traversing S1 nerve root . Annular disc bulge at L4-L5 . I have had symptoms for 9 months slow onset, I have had a caudal epidural and currently take gabapentin for neuropathic pain (pressure, heaviness up back). I have altered sensation in seat area, scatica (no longer painful altered sensation) and sitting ot walking a distance are problematic for me. I have been offered another epidural or surgery after a 1 month further increase in medication. Is this scan result minor or a concern, should I just continue, I am struggling to work Thanks
posted on Fri, 9 Nov 2012
Twitter Fri, 28 Dec 2012 Answered on
Twitter Sat, 29 Dec 2012 Last reviewed on
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Neurologist, Surgical,  's  Response
Hi Alli,

If your symptoms are sciatica on the left side, it corresponds with your MRI scan and the operation has a statistically greater probability of giving you good relief of the sciatica. In fact, in studies it has been proved that the major benefit from surgery is early return to work. However the choices on the table include surgery, interventional pain procedures like the epidural or continuing with painkillers etc. In the long term, none of these 3 choices have a particular advantage over the other. So you'll need to think through the pros and cons of all the options and choose whats best in your specific situation.

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MRI Scan Shows Mechanical Left Recess Stenosis Due To Disc Extrusion, Disc Bulge. Suggestions?

Hi Alli, If your symptoms are sciatica on the left side, it corresponds with your MRI scan and the operation has a statistically greater probability of giving you good relief of the sciatica. In fact, in studies it has been proved that the major benefit from surgery is early return to work. However the choices on the table include surgery, interventional pain procedures like the epidural or continuing with painkillers etc. In the long term, none of these 3 choices have a particular advantage over the other. So you ll need to think through the pros and cons of all the options and choose whats best in your specific situation. Hope this helps