Doctors Lounge - Surgery Answers
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Forum Name: Surgery Topics
Question: is surgery a option?
|fl cat - Fri Jul 16, 2004 12:39 pm||
My husband has had back problems for many years. It started as a disc heriation and his Dr. advised (in 99) he reduce work hours and physical therapy for stenosis. This did not help. He has been on several differant drug therapys also with little or no relief. In 2002 he saw 2 specalist. Both thought surgery was not indicated. In May of this year he had sudden "foot drop" and was admitted to the hospital. The lumbar myelogram is as follows
L2-L3 There is the slightest degree of bulging of the annulus without a disc herniation. Thiscould be a very early change of disc degeneration.
L3-L4 There is moderate diffuse bulging of the annulus. I suspect there is a small central disc herniation best appreciated on the sagittal reconstruction views.
L4-L5 There is minimal disc space narrowing with a moderate size central, left paracentral and posterolateral disc herniation. This is best seen on the axial reconstructed views. In regards to the patient's foot drop, this is most likely the area of greatest concern. There is also bulging into the right neural foramina but to a lesser degree. No facet changes are seen.
L5-S1 There is complete loss of the disc space, marked end plate sclerosis and osteophytes consistent with rather severe chronic degenerative disc disease with a moderate size central osteophyte as well. The annulus shows diffuse bulging, and there is some calcification of the annulus and a small central disc herniation. Even though there is advanced degeneration, the nerve roots appear to be reasonably well filled. There has been a partial laminectomy on the left side.
The surgon at the hospital said he was not a cadate for surgey, but his GP basicly said if he does not get surgey soon he could face more paralysis. What are his options? If he has surgery will it improve his condtion or only halt further degeneration? Also what is a laminectomy?He has not had surgey on his back bofore but the did try some injections at one point.
|Dr. Tamer Fouad - Sun Jul 18, 2004 2:45 am||
Dear fl cat,
I am sorry to hear about your husbands condition. Surgery is his only option if he is to avoid further deterioration. The surgical options infront of him include a laminectomy +/- discectomy. Did his surgeon say why he is not a candidate for surgery? Neurological compression that is not releaved within a week or two from the start of paralysis is usually very difficult to treat afterwards as the nerves have most likely died of ischemia by then.
Have a look at our disc herniation page for more info.
Maybe you should get a third opinion from another neurosurgeon.
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