Re: BACK PAIN

Posted By CCF MD mdf on May 26, 1998 at 12:57:09:

In Reply to: BACK PAIN posted by CARROLL CALLINAN on May 26, 1998 at 11:36:50:






Recently I had a MRI done and this is what the diagnoses: Right posterolateral disc herniation seen at L4-5.  This is associated with a small extruded disc fragment which extends inferiorly from the disc level posterior to the L5 vertebral body on the right side.  There is slight deformity of the right ventral aspect of the thecal sac and impingement on the traversing right L5 nerve root.  Clinical correlation of a right-sided radiculopathy particularly a right L5 radiculopathy is recommended.  It has been a month since I did this and I have been going to a chiropractor 3 times a week, trying to align my back.  My pain passes down the right side of my leg to my foot.  I have been told to give it time and it might go away.  I have also been told to have the operation done.  I woul greatly appreciate if could suggest what type of operation would be the best for me with little incision. Also, do you think it's wise to wait before having this operation done?  Any help would be greatly appreciated.
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The MRI certainly suggests an abnormality. The trouble is, that isn't the whole story when it comes to making a decision to operate. I had a herniated disc at L4-5 which resulted in a great deal of pain, some numbness, and slight weakness. I recovered over a month or so (with physical therapy and some ibuprofen), but my own MRI report sounds like your own. The moral: the MRI itself shouldn't be the deciding factor, because even "bad" herniations don't need an operation.
I am conservative by nature. I think your best bet is a second opinion. It could be that physical therapy may be a better option than chiropractic. You may benefit from certain medications rather than others. You might even be advised to get an operation, but I'd want to be sure that all other options have been exhausted first. There is a realistic possibility that your back pain could get better over the next few months with appropriate therapy.
You are welcome to contact the Spine Center here at CCF. Call 800 223-2273, ask for 4-5559 (neurology appointments).
As you know, this information is provided for your general medical education only. Any specific comment regarding diagnosis, prognosis, and treatment options must come from your doctor after appropriate evaluation. CCF MD mdf.