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Member
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Join Date: Jan 2009
Location: Paradise
Posts: 855
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Member
Join Date: Jan 2009
Location: Paradise
Posts: 855
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Quote:
Originally Posted by shub90
I am very much thankful for your information. Could i ask you if you are a docter ?. And I was wondering why they have bold the words 'Note is made of lipoma of filum terminale' is it a very important/serious finding and the underlined canal diameter at disc level values Mainly at L4/L5: 08.8mm, L5/S1:07.4mm (how severe are these ? ).
 And i will keep updated you on her progress. She is experiencing pains early morning when waking up. Also she is trying alternative therapies like homeopathy, acupuncture. I was researching online and lots of people have said surgery isn't the best option but the last option. I have also read about Mckenzies methods. I am telling her to do them exercises as physiotherapist in India ain't the best  which makes me very worrying. |
Hi,
There is a lot left unsaid. There is nothing known of her specific complaints and more importantly, her clinical findings (reflexes, sensory findings, motor grading, orthopedic tests, etc.). MRI's are ordered in this scenario to confirm diagnostic suspicion of "some" clinical entity or working diagnosis, based off of the chief complaints and objective findings (for which we know nothing about). MRI findings without knowledge of the reason and basis (exam findings) for which it was ordered are almost meaningless. Especially since only one image (a sagittal) was thumbnailed out of 50-60 (sagittals and axials both T1 and T2 weighted images) or so that were probably produced.
That said, based off of the report there are definitively problems at L4-L5 by way of disc hernia, extruded fragment with root compression. The statement about canal diameter could be important for her as a diameter of less than 10 or 12 mm or so is termed absolute stenosis which "may" label her as a likely surgical candidate. It really comes down to her clinical findings.
So while I agree with Leesa that surgery for only lower back pain might yield a lower success rate to reduce pain (exceptions of documented segmental instability, ominous origin and a few other reasons), if her predominant complaint is radiating pain into the buttocks, leg or foot, weakness, numbness or tingling of the same and/or combined with reflex, sensory changes, motor loss or tension signs (+ straight/well leg raise), then decompressive surgery has a much higher chance of reducing that kind of pain. Cauda equine syndrome, acute or progressive motor loss, loss of bowel or bladder control are potentially emergent, surgically,
I think mom really needs to check-in with an ortho/neurosurgeon for advice; good luck to mom!
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