Disc extrusion, nerve compression. Do I need surgery?
In the past year, I have had 3 episodes of severe lower back pain, each lasting aprox. 3-4 weeks. 2 months ago, I experienced another one, but this time the pain went down the back of my right leg as well. While driving to work one day, the pain was so bad that I had to pull over to stand up and try to stop it. When I got to work, the outer side of my right foot was numb. This combined with the pain prompted me to go to the hospital the next day. I was diagnosed with sciatica and had an MRI booked. After that was done I went to see my doctor. She reviewed the report and referred me to a surgeon. She mentioned that they may want to remove one of the discs in my back, which makes me nervous. Any other suggestions or options?? I am only 27 and would prefer to not have this be a lifelong condition.
Here are the MRI results, hope they help.
MRI THE LUMBAR SPINE
There are five lumbar vertebrae.
There is a minor scoliosis of the lumbar spine with convexity to the right. The vertebral body height is well preserved at all levels. There is no abnormal signal seen. The conus ends at the lower border of L1.
At L2-L3 and L3-L4 there is no disc disease seen. The spinal canal is adequate.
At L4-L5, there is minimal diffuse disc bulge seen extending into the neural foramina bilaterally with no compromise of the exiting nerve root.
At L5-S1, there is significant disc desiccation and disc height narrowing. A large focal right para-central disc extrusion is seen at this level measuring approximately 1.2cm in the maximum AP and 1.9cm in the maximum transverse dimension. Craniocaudally, this measures approximately 2.6cm in length. This exerts significant compression of the exiting right L5 nerve root and mass effect on the traversing right S1 nerve root which is displaced posteriorly. There is also significant indentation on the right anterolateral aspect of the thecal sac from the extruded disc. In addition, there is mild diffuse disc bulge also seen at this level which exerts narrowing of the neural foramina bilaterally. The left exiting L5 nerve root is however not compromised.
A right paracentral disc extrusion at L5-S1 level exerting significant compromise of the exiting right L5 nerve root and mass effect on the right traversing S1 nerve root.
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