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I need urgent advice from the doctors of the board
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[quote]Wa'alaykum Asallam. I am not an orthopedic specialist or a neurologist but a gp. I enclose my views. My understanding is that your husband has a disc prolapse at L5/S1 level.he is getting numbness and pain down left leg which in layman's term is called sciatica. Sciatica is a pain caused by pressure from a bulging disc or bone on sciatic nerve. It supplies the leg and thus due to the pressure on the nerve, he is getting pain and numbness. Disc prolpse can occur in a younger age.Normally, pts are given approx 6 months for recovery by conservative. (non-operational) treatment.this entails physiotherapy, local injections and pain killers. If by that time recovery is not occuring then,surgery may have to be considered. Spinal surgery is done as a last resort and not as a first option.when all other measures fail.by this time I would presume that your husband has had an MRI scan to confirm nerve root irritation and pressure ie the nerve is under pressure from the disc. At this stage the surgeon considers the option of a spinal operation called spinal decompression ie taking the pressure off the nerve,by removing the disc and spinal fusion; fusing the adjescent vertebrae. There are two other points to consider.Firstly,you have written that your husband is young.If the operation is not done then persistent pressure from the disc can lead to permamnent damage and weakness of nerve in future, thus delaying the operation or not having an operation not only means that his pain and suffering will persist but it may get worse and the likelihood of spontanous recovery after 10 months seems unlikely. Secondly! whilst you have given general information. every case is an individual case with its own complexities.Whilst we can discuss general pros and cons,my adv is that I would be guided by the orthopedic specialist. If he/she feels that an operation is required then I will put my trust in him/her. My understanding is that spinal specialists do not offer operation if they feel it is not required. I agree that spinal operations carry higher risk then ordinary operations like appendix or hernia or gall bladder,but they are performed by skillful specialists. If I was the pt, then I would feel that after 10 months my chances of recovery without operation are very remote. I would discuss with my orthopedic specialist and if he/she suggested operation ,I would put my faith in them. Kind regards[/quote]
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