Q. What does abutment of the nerve root mean?

Answered by Dr. J Mariano Anto Bruno Mascarenhas and medically reviewed by iCliniq medical review team.

 

New
Do you have a question on Disc Bulge or Nerve Compression? We have medical experts to help you right away. Ask a Doctor Now »
Image: What does abutment of the nerve root mean?

Hi doctor,

I am just wondering what is abutting and abutment of the nerve root means in a back issue. Please explain. What treatment is required for annular bulging and tear?


Related Questions:
Will you recommend fusion surgery for disc extrusion?
Can you look at my MRI and explain the reason for burning pain in feet?
I am having pain behind breast that is radiating to underarm. Please help.
 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome to icliniq.com.

I have gone through your query with diligence and would like you to know that I am here to help you.

  • Abutment of nerve root means that the disc is touching the nerve root.
  • Treatment of disc bulge alone is mostly non-surgical means. If there is annular tear, then you will need surgery sooner or later and sooner the better.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

I have had lower back pain and left leg pain for over two months. I had two MRI scans and have been diagnosed with a broad annular tear and bulging disc into my nerve roots. What is your take on the photos of my L5/S1 disc? Is the tear a big one? What is your recommendation on the treatment options?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

I have gone through the images (attachment removed to protect patient identity).

  • The tear does not appear big, but there is compression of the left nerve root at this level.
  • In my opinion, based on these images, I would advice surgery. My choice would be discectomy and foraminotomy on the left side.
  • As of now, you are having only pain. This is a very good time to operate.
  • You are also having osteophytes (bony projection) and canal stenosis. In due course, you may develop weakness of your great toe. It is better to operate before further complications develop.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

Are sure that there is an annular tear?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

  • In axial view, there is an irregular shape. The smooth curve is altered and we see an out pouching in the left side.
  • In sagittal view, there is a black line in the posterior part and there are osteophytes. These findings are suggestive of tear in the annulus in the left side.

For further doubts consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

I have just seen a neurosurgeon today regarding the injury, we have talked about. He stated that I have an annular tear and disc bulge, but the bulge is not big enough to cause my left leg pain. He suggested surgery is not needed and the tear should repair itself with a strong physiotherapy program. I have been told opposite from another doctor that physiotherapy could cause more damage to the tear. What is your take on this?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

  • As per the images, you have sent to me, there was an annular tear and prolapse of the disc.
  • If there is a generalized disc bulge (without an annular tear), the bulge can go in with physiotherapy. But, when there is an annular tear with herniation of nucleus, there is no chance for it to heal by itself.
  • The second doctor is correct. You have pain for two months. You have annular tear and prolapse as per MRI. All three of these say that surgery is needed.
  • Physiotherapy is not useful now and maybe even harmful at the current stage.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

If I did not get surgery, then what is my future with this tear? How long does it take to recover from the surgery? Is there a possibility of recurrence of tear as I did work in a heavy lifting job?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

  • Spinal canal is a small space and the foramen through which nerve roots exist is an even smaller space. Now, there is an annular tear in the disc. Through this tear, the nucleus of the disc has protruded out.
  • The protrusion of the nucleus creates two problems. Chemical irritation of the root and mechanical compression of the root.
  • Your pain for the past two months is because of this and so the treatment would be removing the prolapse part of the disc.
  • This surgery is very much needed. Without this surgery, the root will be continued to be mechanically compressed and chemically irritated.
  • Right now you have only pain. After some time, with continuous irritation and compression, you may have weakness of the toes or foot. So, please undergo the surgery as soon as possible.
  • Once you do a surgery, you may need bedrest for two weeks and light work for six months. After that, you can return back to your work.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

I have attached a photo from my MRI showing something pressing on a nerve. Can you explain what it is? I have not visited my doctor yet. Also, I have developed a sharp pain in my toes for the last five days and redness on the top of my left foot. I never had this before. Is this something related to nerve issue?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

  • I am not sure about the sequence of this (attachment removed to protect patient identity). If this is myelogram, then it is prolapsed disc pressing the nerve root.
  • Your pain is likely to be due to the disc prolapse, which is irritating the nerve root.

For further doubts consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 

Thank you doctor,

The sequence is from an MRI it is a T2 coronal. I have attached two photos of the MRI. Can you do a pointing like you did with the other ones for my reference?

 

Dr. J Mariano Anto Bruno Mascarenhas
MBBS., MCH NEUROSURGERY
Neuro Surgery, Neurology, Spine Health, Spine Surgery

Hi,

Welcome back to icliniq.com.

Thanks for uploading the images (attachment removed to protect patient identity).

  • The compression is due to the same disc, which we have already seen.
  • In this image, you are seeing the compression from the front and in the earlier images, you had seen that from the side and from above.

For further doubts consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

 
 
Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.

Related Questions & Answers


When I start walking, the portion below the knee is numb. Why?
Query: Hello doctor, I am 44 years old. From the last one month, I have problems with my legs, especially my left leg, when I get out of my bed or chair and start walking, the portion below the knee is sleeping (numb), sometimes it happens in the right leg as well, but most of the time in my left leg. I w...  Read Full »
Dr. Lokesh
Orthopaedician And Traumatologist

Answer: Hello, Welcome to icliniq.com. It can happen due to nerve compression in the spine or below that. Also can be due to vitamin B12 and calcium deficiency. So you need to get investigated properly, with vitamin testing and MRI scan. Regards, This is only a second opinion platform. This professional...  Read Full »
 
I have spasms and pins and needles sensation in my hand. Please help.
Query: Hi doctor, I am having spasms in my hand. I had it briefly in the left hand and then, my right arm was feeling numb. This morning my right hand has spasms on all fingers at different occasions with some pins and needle feeling. Please help.  Read Full »
Dr. Sudheer Ambekar
Neuro Surgeon

Answer: Hello,Welcome to icliniq.com.You might have nerve compression from cervical spondylitis.Please consult your GP to get an MRI of the neck.For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist  Read Full »
 
Can exercise improve muscles that are affected by nerve damage?
Query: Hello doctor, I am 65 years old, male, otherwise in good health but BMI around 31. I have a damaged spinal cord at C4 (due to disk herniation) and had anterior discectomy with fusion in 14 years back. I have had left sided peripheral neuropathy since my surgery (15 years). All sensory, no motor iss...  Read Full »
Dr. Aida Quka
Neurologist

Answer: Hello, Welcome to icliniq.com. I read carefully your question and reviewed your uploaded test reports and would explain that physical activity is important to maintain a normal muscle force and avoid muscle stiffness due to a damaged spinal cord. Regarding neuropathy, maybe it cannot help improve ...  Read Full »
 
 

Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.
 

Ask a Doctor Online

* guaranteed answer within 4 hours
 

Most Viewed


Sepsis - Causes|Symptoms|Risk Factors|Diagnoses|Treatments|Prevention
Sepsis is a medical emergency, as it causes multiple organ failure. When the body's response to infection in the blood s...  Read more »
I have on and off acid reflux as well as mild dysphagia. Is this esophageal cancer?
Hello doctor,I am a 26-year-old male. I have been experiencing on and off acid reflux for a few weeks as well as mild dy...  Read more »
There is a hard lump under the nipple. I am afraid of breast cancer. How to proceed further?
Hi doctor, I am a 25-year-old female. I found a quarter-sized hard nonmobile lump under my nipple a day ago. Is that an...  Read more »