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Serious Condition or Hang Nail?
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Serious Condition or Hang Nail?

My hubby, (56 y/o), with low back pain 5+ yrs accompanied the last 8 mo by leg numbness, weakness, stumbling. Conservative treatment-2 years. 5/8 MRI findings: Diminished hydration signal of disc material at all levels indicates disc desiccation, degeneration. T12-L1: Broad based posterior protrusion of disc material centrally; L1-L2/L5-S1: Posterior bulging annulus fibrosis; L2-L3: Disc degenerative change; L3-L4/L4-L5: Same as T12-L1+Moderate facet arthritis, thickening ligamentum flavum, lateral recess bilaterally and neural foramen narrowing-right side posterior lateral protrusion disc material; L5-S1: Posterior bulging annulus fibrosis. Neurosurgeon's interpretation: Moderate  stenosis, discs not causing neuropathy. 6/24 Peri-vascular normal. 7/26-Nerve study: Ooverall moderate neuropathy-diabetes. Needle probes spinal neuropathy (left leg minimal reaction). L5-S1 surgery recommended. Why lack urgency-appts month apart- report to surgeon same day-still no contact.  Diabetic neuropathy? Hubby's diagnosis within 1 yr and his 3/6 month average tests on high end of normal range. He has been told by family Dr. that the back pain could result in false readings for his daily results. 3. What about the other bulging discs? 4. What kind of surgery will likely be recommended? 5. What is prognosis? 6. Recovery? 7. I'm fairly confident he also suffers from undiagnosed sleep apnea as he is a heavy snorer and stops breathing for 30-45 seconds (if not more) numerous times every night. How will this effect his recovery/surgery? 8. What about the spinal stenosis? Footnote: Family history-Mother diabetes and neuropathy resulting in foot amputation. Father incapacitated by degenerative arthritis resulting in nursing home care at age 50. Any insight you can share would be greatly appreciated! Both hubby and I feel that his physicians' casual attitude seems to indicate his condition is not that big of a deal, but I'm WORRIED SICK!
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1083596_tn?1313398276
Dear Friend,
Many thanks for the post and giving me an opportunity to guide you.

1) Why lack urgency-appts month apart- report to surgeon same day-still no contact.
       The present MRI scan doesn't justifies any emergency.

2) Diabetic neuropathy?
     Need to prove the same with high Glucose in the blood (esp the glycosylated HB)

3. What about the other bulging discs?  
        There are multiple level disc bulges, but presently can't really comment as whether surgery will help or not. There should be a proper course of Back Physiotherapy and then we can see, if it's helping or not.

4. What kind of surgery will likely be recommended?
      Surgery can vary from simple disc removal to Laminectomy to Posterior fusion, depending upon the need of that hour.

5. What is prognosis?
       Successful surgery has a good outcome.

6. Recovery?
       If successful, good recovery.

7. I'm fairly confident he also suffers from undiagnosed sleep apnea as he is a heavy snorer and stops breathing for 30-45 seconds (if not more) numerous times every night. How will this effect his recovery/surgery?
      It may have an effect. Need to do sleep apnea study, before commenting on it further.

8. What about the spinal stenosis?
     Spinal stenosis, if leading to nerve tissue compromise can be an emergency, especially if it's hitting on the region where there is bladder involvement. Laminectomy is preferred.

Feel free to discuss further.
Regards
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