HomeAnswersOrthopedician and Traumatologydisc extrusionIs fusion surgery a good option for disc extrusion?

Will you recommend fusion surgery for disc extrusion?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At June 30, 2016
Reviewed AtJuly 26, 2023

Patient's Query

Hi doctor,

Four years before, I met with a car accident with no external injury. After a week, I started getting pain in my right buttock and calf area. Later, I was recommended for an MRI and found it was an L4 to L5 disc extrusion. I underwent a microscopic discectomy the same year. Now, for the past month, I am having severe pain in the same area. I consulted my surgeon and took another MRI as recommended. This time as well, I have the disc extrusion in the same disc. This time he is recommending fusion. I am attaching the MRI reports for your kind advice. Please check and advise whether I need to go for it. My current medications are Renerve Plus and a painkiller.

Hi,

Welcome to icliniq.com.

A few observations are as follows. Your pain is on the right side and the MRI (date of examination not visible) says about the disc with stenosis more on the left side (attachment removed to protect patient identity). Kindly inform me about any neurologic defects that your doctor found on clinical examination Could you be more specific on your current and past walking distance, standing time, pain aggravating factors, etc.? The MRI sections in the second and the third attachment shows a degenerate disc with extrusion more on the right foraminal para central areas with lateral canal stenosis. No doubt that you can be helped by surgeons, but fusion is the end of surgery. You can have a lot of problems like decreased movement, adjacent segment degeneration, implant and fusion-related problems, increased cost, neurologic damage chances, etc. Instead, first I suggest that you discuss transforaminal endoscopic discectomy with your doctor. You have a lot of advantages with this new procedure. These are fusion alternative surgeries that a young person like you will mostly benefit from.

Thank you.

Treatment plan

Evocative discogram proceed transforaminal endoscopic discectomy.

Patient's Query

Hello doctor,

I am really grateful for your detailed advice. It is giving some positive news to me as I consulted almost six doctors and all recommended the fusion which was my cause of worry. Regarding neurologic defects, my doctor did not mention anything about that. Post my earlier surgery, I was able to go for a morning walk of around 4 km, for every 2 km, I took a five minutes break since I felt some stiffness in my lower back. I was able to stand for around 5-10 minutes. After that, I get the same stiffness as mentioned above. Almost a month back, I went to the office and had severe low back pain where I could not sit, stand, walk, or sleep. Then my doctor advised me to bedrest for almost six days and later the low back pain was reduced by 50 %. But, the buttock and calf pull on the right side was not reduced. In fact, during sleep, I get up many times due to this pulling pain. I had some severe tingling effect and a severe hot feel on my right foot. Later, I was advised with Neugatrip, Etoshine, and Renerve Plus for a month. With these medicines, I was able to manage my pain. Now, I am almost going to complete the one-month course. I stopped walking due to the pain and I am unable to stand for more than 4 minutes. In the office, I will get pain in the lower back if I sit for more than 30 minutes. While getting up from this position, I get lower back pain along with buttock and calf pulling pain for a few seconds.

Hi,

Welcome back to icliniq.com.

I have not seen your X-rays. But, I still believe that your symptoms are due to your L5-S1 nerve pressure and chemical interaction. For further pain, you could undergo a transforaminal epidural steroid injection, which is a day care procedure and get interim relief. In the meantime, please get updated on these path-breaking new procedure. I will be even more informative if I can see your earlier MRI, x-rays, doctor's notes, operation record, present doctor notes, etc. Then, I can form a firmer opinion and guide you better.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Palani Kumar Chellamuthu
Dr. Palani Kumar Chellamuthu

Spine Surgery

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Orthopedician and Traumatology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy