Concluded Case

50 year male, sciatica Lt leg, SLR+, vas6-7, ehl edl weak... MRI presented..comment

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Concluded answer
this patient has a classical L4-5 , L5-s1disc prolapse which was symptomatic and needed surgery.. the interesting thing was that I found additionally a tumor at L1 which is neurofibroma and was asymptomatic... I removed both at single sitting and patient is already back to work in two weeks
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Need to be evaluated with MDT assesment And cheked for centralisation of symptoms and directional prefrance. If patient responds to evaluation than Can be treated with proper physiotherapy and education to save surgery.
I find a lesion may be the one shown in the attached pic? I may be wrong @Dr. Yashesh Dalal sir
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Ligamentum flavum is compressing spinal cord in lumber region
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this patient has a classical L4-5 , L5-s1disc prolapse which was symptomatic and needed surgery.. the interesting thing was that I found additionally a tumor at L1 which is neurofibroma and was asymptomatic... I removed both at single sitting and patient is already back to work in two weeks
Disc herniation prominent from L3-L5 if pt. Is not diabetic it's better to go for surgical correction since medicines shall be ineffective in this case . After surgery needs to follow up for physiotherapy for atleast 5 months to recover.
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Disc herniation c nerve route compression more prominant at L3.L4. L4 L5 ,better to go for surgical correction
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He must be having neurogenic claudication.needs surgery.
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All are missing something else seen also

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