Is back surgery required for degenerative disc disease?
Patient: I have had severe back pain for many years and my recent MRI report reveled degenerative disc disease and L3- L4- L5 L5-S1 diffuse disc bulging and Spinal Stenosis moderate central spinal canal narrowing at L-4 and L-5 and ligamentum flavum hypertrophy and focal disc herniation, can you explain this to me and would I be a candidate for back surgery? Doctor: Hello Thanks for writing to HCM According to reports you have degenerative disc prolapse of spine in lumbar region.1.You have diffuse disc bulge at L3-L4-L5 and S1  level and herniated disc is causing moderate stenosis of central spinal canal at L4-5 level.This is causing pain in your case.There is also ligamentum flavum hypertrophy and focal disc herniation.Degenerative changes occurs due to aging and development of weakness in annulus fibrosis which allows herniation of disc.Treatment for pain includes physiotherapy or surgery. Effectiveness of both modalities are same.So,physiotherpay should be tried first. It causes strengthening of Para spinal muscles and it prevents further changes. Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Other pain relieving modalities are Ozone ablation,Radiofrequency ablation,percutaneous disectomy etc.Treatment can be planned after consultation with neurosurgeon.You should also modify your life style like don't abruptly bend forward and avoid standing for long time.Don't lift heavy objects.Get well soon. Take Care Dr.Indu Bhushan