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Central dsic protrusion l5-s1

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:28 AM in Lower Back Pain
Can anyone tell me if this requires surgery??

"Central disc protrusion at L5-S1 causing anrrowing of the lateral recesses bilaterally without frank stenosis. Bilateral foraminal narrowing is noted as well at this level."

My husband is in terrible pain and can find no relief. We have tried PT and injections. Is there a way to prove or disprove that the pain he has is from this disc?
We are told that he is not a canidate for a fusion becuase his tests (MRI) don't show that the pain is from the disc or from a unstable spine. But I keep reading that the central disc protrusion should be fixed via surgery. Wht should we do??


  • there is a test called a discogram which I am acually going for soon that can pin point what disc is " the pain generator" they exspand the disc with I believe saline and try to make it hurt and when it duplicates the pain that is the bad disc. I hope this helps you a little .Remember we aren't doctors just people that are in the same boat giving our experiences to you always check with a doctor before doing anything.Good luck to you and your husband
  • I can totally relate to how your hubby feels. I started out with a central disc herniation @ L5-S1 and tearing @L4-5 which thankfully your hubby does not have. I also just want to say that just like everyone else I can share my experiences and opinions only and in the end we all must be our own advocates, follow our gut and discuss your plan of care with your doc.

    That said I may sound like a broken record in alot of posts I do but I guess some things cannot be said enough and that is I think we all should get a second or third opinion. I think chirogeek.com (I have no connection to the site) would be a great site for ya'll to check out. It discusses different types of herniations. As you may have already read or will read a central herniation is one that should be watched closely, the website discusses why and all of that.

    As my herniation got worse and worse it became more than pain. Does your hubby have any numbness, tingling, weakness, pain running down a leg, or any other neurological symptoms? I had some of these and after exhausting all other things I thought I needed a simple laminectomy/discectomy. I am among the not so normal though as the disc herniated rapidly. So now I'm looking at a fusion, looking back I should have done something sooner but no one thought my disc was going to be a stinker. I did the normal things that are prescribed and most of the time people do not need surgery especially if there isn't any nerve compression.

    So now my doc says we better check the disc above(looked only black on the MRI) to make sure the problem is the said disc. At this point I had severe foraminal narrowing AKA compression of the nerves that run through there and loss of disc height which is why it's at the point of fusion. The doc ordered the discogram and sure enough the L4-5 is shredding. The discogram is not a for sure test but if they duplicate the same type of pain you normally have they feel like it may be the disc. It is only 1 test in the whole picture, I did not decide on surgery based on this test alone.

    I think what you've read about central disc herniations is not to be taken lightly. No herniation should but when it's central obviously as the disc herniates it may be more serious if it's not on the side of the discs.

    What is REALLY disturbing is what you said you were told that the MRI "doesn't show that the pain is from the disc or from a unstable spine" It is impossible to decide on a treatment based on what a MRI looks like. There could be 10 MRI's that all look the same and most will have no problems some will and those that do may all be experiencing different problems. I was wondering is that your medical doc or a specialist that told you that? I also wonder why a fusion? If there is no instablility why not a laminectomy to decompress the foraminal narrowing and a discectomy to remove the protrusion that has leaked?

    I am NOT saying this is what should be done or anything I am saying to maybe ask this question so a doctor can give you the reasons. I would definitiely ask this doctor and seek a second and third opinion from a neurosurgeon, or an ortho doc with a fellowship in spine surgery. You'll need to take the MRI films and any other test results, film as well. I wouldn't count the first doctor as a first opinion if he discounts your hubby's pain and ongoing problems after non-surgical treatments have been tried. A fusion should be a last resort.

    My mom-in-law had L4-5 herniate & as soon as she got out of surgery from a laminectomy/discectomy she felt so much better just getting that stuff out of there. This one was getting quite serious she was getting to a point where she could not move her foot. This was let go for so long as the radiologist read the film incorrectly and the primary doc dismissed her pain based on the radiologist's reading which noted a bulge or something and did not indicate how serious it was at that time... A year later the other side herniated(no where near a s severe as the first time). She had another discectomy with the same results post-op.

    I hope this helps I know it's long but I can't help but share a little of my story so as to prevent an extrusion which ultimately happened to me, I wasn't helping myself by lifting, pulling, twisting and all of that stuff my job required. So I am not saying It's going to happen because like I said it normally doesn't so fast as mine did but just be vigilant your hubby knows there is something wrong he's in alot of pain and a test is just a tool in the whole picture. This doc is not looking at the whole picture he has dismissed the clinical part of it.

    Good luck

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