"marginal osteophytes"

Dear Ask The Doctor: Dear Sir, My Father is suffering from pain below the hips,causing him not to walk (or barely walk with complete body bend) We have got his MRI L-S SPINE done at Ranchi. The MRI L-S SPINE report has the below remarks : Findings : - Prominent marginal osteophytes, including posterior ones and endplate changes are see at multiple levels. Lumbar vertebrae are normal in height. - Posterior herniation of L4 - 5 iv disc with ligamentum flavum thickening is causing compression over cauda equine and emerging nerve roots, bilaterally. - Posterior herniation of L3 - 4 iv disc is causing compression over emerging nerve root on left side and indentation over emerging nerve root on right side. - Posterior bulge of L2-3 iv disc is causing narrowing of the iv foramen bilaterally. - Posterior bulge of L1-2 iv disc is also seen. - All lumbar iv discs are hypointense on T2W images, indicating disc desiccation. - Conus medullaris is normal in morphology and signal intensity on all pulse sequences. - No pre or paravertebral soft tissue abnormality is seen. Impression: MRI Study reveals: - Marked Lumbar spondylosis. - Posterior herniation of L4-5 iv disc with ligamentum flavum thickening causing compression over cauda equina and emerging nerve root,bilaterally. - Posterior herniation of L3-4 iv disc, causing compression over emerging nerve root on left side and indentation over emerging nerve root on right side. - Posterior bulge of L2-3 iv disc, causing narrowign of the iv foramen bilaterlly. Please! let me know the treatment procedure  Thanks in advance for your quick response. Bal Krishna

Dear Bishnu Prasad: According to the report of your father MRI there are signs of degenerative bone changes (osteophytes/ spondylosis) and lumbar nerve root compression in 3 levels L2-L3, L3-L4 and L4-L5, which is causing the pain and the disability to walking. The treatment options depend on the age, severity of the pain, neurologic symptoms and if he has some other associated health issues or conditions. He may try with conservative treatment first as physical therapy and if there is poor or no improvement he should get a re evaluation by a orthopedic surgeon to decide if surgery  may be consider as a treatment option for him.