Severe lumbar spondylosis, Multi-level disc protrusion with exit nerve root comp, pain in right leg
Patient : I have been having a lower back pain for more than 3yrs now coupled with pain in my right leg. Am a male adult of 34yrs. Doctors have been giving me pain relief medication which only ease the pains for a short while. However it starts getting worse the past one year. Sometimes the pain will be so sharp that I will fall back to my sitting position if i was attempting to stand up. Atimes it occurs when am walking and I'll let out a sharp cry and stay put. My right leg feels light and numb and some heat sensation most times and it's worse when I want to sleep as I'll not be able to find a posture to ease the leg pains.
MRI scan returned with the conclusion of (1) Severe lumbar spondylosis and (2) Multi-level posterior disc protrusions with exit nerve root compression.
Here is the detailed findings:
- There are anterior disc-osteophyte complexes at L1-L2 and L2-3 levels with elevation of the anterior longitudinal ligament. Note posterior disc osteophyte complexes at all lumbar levels with indentation at the anterior thecas.
- Also note broad-based posterior disc bulges at all levels (except L5-S1) with narrowing of the neural foramina and impingement of the exit nerve root.
- All the disc (except L5-S1) show mild fissuring
- Schmorl's nodes are seen at L1-2 and L2-3 discs with adjacent end-plate signal changes (hypointensities in all sequences) - indicative of MODIC type III (chronic) degeneration.
- Lumbar spine shows near reversal.
- Spinal cord terminates normally at L1 level and its demonstrated portion is normal in morphology and signal.
I have been on physiotherapy for one month now but there is no noticeable improvement at all.
Surgery was recommended as a last resort but my worries are about the delicate nature of the spine and the implication if anything goes wrong.
Please doctor what is the implication of this scan result and what is the worse that can result from such conditions? Would you recommend the surgery or to continue with the physiotherapy?
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