I have had moderate to severe sciatica all the way to my ankles,three toes of one foot are numb. MRI shows moderate disc bulge at L3-4, mild to moderate central stenosis L4-5, moderate to severe bilateral facet hypertrophy L5-S1, my flex/extension x ray shows anterolisthesis L4-5 6mm flexion 2 mm extension. I do not know what grade this is. My neurologist says I may need a fusion possibly with decompression. PT has not helped. I am wondering if these stats and level of pain generally require surgery.
Well, this would be a difficult question to answer without knowing the relevant clinical details. ‘Moderate’ is still a relatively vague comparison and could vary; however yet f conservative measures have not been helpful for symptomatic control, surgical/ interventional measures are usually indicated. Just to be sure about the management plan you may like to get a second opinion from another orthopedician.
Hope this helps.
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