Concluded Case

L4-5,L5 S1 disc protrusion with foraminal compression

TODAYS OPD CASE. 46 yr ,F, Developed severe pain in the lower back with radiation to left lower limb on 28th Dec 2020 while getting up from sitting. Evaluated at local hospital and was suggested surgery. Patient refused for surgery and is on Ayuvedic treatment,and she is feeling better.The present problem is weakness of left foot with parasthesia left leg and left gleuteal area.No bowel or bladder dysfunction noted. No previous history of any medical illnesses. On exam vitals stable . Normal built,wt 58 kg.Lower limb exam shows dorsiflexion weak left side Weak extensor hallusus longus with absent left ankle jerk with dulling of sensation left L5 S1 dermatome. Patient is ref to spinal surgeon but reluctant to see him today. Diagnosis and management?

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Concluded answer

Thanks to all doctors who answered. MRI teport: Diffuse broad based disc bulge with protrusion compressing ventral thecal sac,compressing bilateral exiting nerve roots,narrowing neural foraminas at L4-L5.. Diffuse broad based disc bulge with pisterolateral large disc protrusion with caudal migration with mild facetal arthropathy,severely compressing left exiting nerve roots,moderately narrowing bilateral intervertebral foramens at L5 S1 . Ref to spinal surgeon. Posted for elective surgery

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Thanks to all doctors who answered. MRI teport: Diffuse broad based disc bulge with protrusion compressing ventral thecal sac,compressing bilateral exiting nerve roots,narrowing neural foraminas at L4-L5.. Diffuse broad based disc bulge with pisterolateral large disc protrusion with caudal migration with mild facetal arthropathy,severely compressing left exiting nerve roots,moderately narrowing bilateral intervertebral foramens at L5 S1 . Ref to spinal surgeon. Posted for elective surgery

L4/5 and L5/S1 ivdp with root compression and canal stenosis Will benefit from surgery Neurosurgery evaluation

Valuable opinion
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Lumbar stenosis l4l5 Radiculopathy Emg Opinion of neurosurgeon Orthopedic

Sciatica with disc prolapse? Neurosurgeon's opinion & PT.

IVDP L4-L5 & L5-S1 with Canal Stenosis with root compression more on the left side...Better to go Post Decompression with Laminectomy with root clearance +/- Discectomy with or without stabilization...

Diagnosis _L45,L5S1 disc prolapse with L5 and S1 nerve root compress left side with grade 1 or 2 listhesis Treatmen plan is surgical ...discectomy and fixation depend on stability of spine

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