May 2000: stopped work .. severe left-side sciatica.
medications/treatments
-Tylenol #3 Robaxisal Celebrex Vioxx
-acupuncture
-MRI #1:. degenerative annular bulging at L4-L5/L5-S1, some herniation at L4-L5, narrowing of central spinal canal at L4-L5 level. Desiccation of nucleus pulposus discs from L2-S1.
-epidural steroid injection
-facet and SI joint cortisone injections + trigger and pyriformis muscle injections
-Methadone Neurontin Fentanyl patches
- MRI#2 . L3-L4 a left posterolateral disc herniation indenting dural sac and impinging on left priximal L4 nerve roots; central disc herniation L4-L5 producing stenosis of bilateral L5 nerve roots
Dec 2010, pain intensified, can’t sit, stand, lie down.
-Jan 25/11- MRI#3
T12-L1 OK
L1-L2 Mild bilateral degenerative facet disease, greater on right. Minor broad-based posterior disk bulge with left paracentral 2 mm disk protrusion. Adequate central canal and bilateral neural foramina.
L2-L3 Left paracentral disk extrusion 7 x 4 x 2.5 mm (CC x AP x TR). Bilateral degenerative facet disease ; associated ligamentum flavum hypertrophy. central canal and neural foramina OK. Protruded disk appears to contact traversing left L3 nerve root within central canal.
L3-L4 Bilateral degenerative facet disease. Moderate ligamentum flavum hypertrophy. Minor broad based posterior disk bulge with 1 mm left paracentral disk protrusion. Adequate central canal, bilateral neural foramina.
L4-L5 Bilateral degenerative facet disease and ligamentum flavum hypertrophy. Minor broad based posterior disk bulge. Adequate central canal, bilateral neural foramina.
L5-S1: Bilateral degenerative facet disease and ligamentum flavum hypertrophy. Minor broad based right posterolateral disk osteophyte complex. Central canal, neural foramina OK.
Questions:
1. Root cause of pain?
2. Recommended treatments/procedures?
3. Physiotheraphy recommended?
4. Surgery recommended? (type, success rate, risks?)
Thank you.