I have central posterior disc herniation with annular tear?

Age:17, Gender: Female

At my l4-l5 i have central prosterior disc herniation with annular tear and a degree of subligamentous extrusion of the disc material, which is occupying the anterior epidural space and causing partial compromise of the left lateral recess with potential for impingement of the left transversing nerve root. There is mild bilateral nerve root exiting forminal stenosis, aggravated by some facet joint arthropathy with widening of the joint spaces and hypertrophy. No direct exiting nerve root impingement is demonstrated at this level. My L5-S1, there is central prosterior and left paracentral and foraminal disc protrusion causing obliteration of the anterior epidural space and partial compromise of the left lateral recess with displacement of the left transversing nerve root. There is also mild stenosis of the proximal aspect of the left nerve root exit foramen with no definite direct exiting nerve root impingement.
Are these results bad and what would you recommend, i have already tried physio for 4 months with symptoms only getting worse, i am also on medication with no improvements, i have tried exercising and avoiding bending or sitting for long periods. I have also tried accupuncture with no change.

More details about the presenting complaint:
Numbness down left leg frequently, shooting pain down back of left leg and stabbing pain under big toe. Doctor said i have decreased quad and hamstring strength bilaterally and slump test produces leg pain bilaterally.

Current medications:
Naproxen 500mg 1 tablet 4 times daily, cocodomal 2 tablets 4 times daily. Doctor said thats the highest dosage they can give me because of my age.

Lab tests performed:
Mri performed.

Height, Weight, BMI
Height (cm) BMI Weight (Kg)
180.00 16.98 55.00



Dr Ahmed Fawzy
Member
Dr Ahmed Fawzy

Hi
Physical therapy should be in the form of back stretching exercise + abdominal strengthening aiming to achieve a posterior pelvic tilt to increase posterior disc space , if you have done that and no progress then surgical treatment in the form of laminectomy is the best option.
By the way Attempting to strength quadriceps will severely increase your pain (biomechanical point of view )
Good Luck

Dr. Ayman Darrag
Member
Dr. Ayman Darrag

As a physiotherapist i revommend unfortunately surgery ,because these manifestations are so hard to recover with conservative treatment only..
Sorry
Feel better soon

Dr Mahaveer
Member
Dr Mahaveer

hi,
if 4 months physio has not helped,then LASER therapy and disc decompressive surgery should be considered.
Physiotherapy should have included leg and lumbar traction.
Usually,surgeries should be avoided but if physio is not helping,then endoscopic disc surgery is recommended.
thanks

Dr.Honey
Member
Dr.Honey

Hi..
Thanks for the query..

In case if physiotherapy, accupuncture and conservative treatment via medication is not effective then the last resort left is surgery..

You should consult an experienced surgeon and get evaluated..

Hope this helps..

Regards..

Dr Masr
Member
Dr Masr

Hi

Regarding your inquiry,

Like my colleagues said, it’s the surgery to be done, after failure of other options, but before that , try to consult another physiotherapist…

wpDiscuz