Is it required to do surgery for spondylotic changes with thecal sac indentation?
Patient: Doctor my sister had back and leg pain and directed to take MRI.  The report says cervical and dorsal spine shows spondylotic changes and disc desiccation and there is a mild compression of bilateral exiting nerve roots at the foraminal lever due to l.5 & 4 disc protrusion.  In the cervical region at c.5 &c.6 level the.is a disc bulge with thecal sac indentation. all other things are normal.  Local doctor suggested for surgery.  Is it necessary and will it give permanent curation or is there is any other treatment which can cure this without surgery. Doctor: Hi.I am Dr Mittal.I have read your message.I think I can help you.However I will need further information.You see, the decision for surgery is most often based on the clinical needs of the patient. The symptoms like difficulty in walking, degree of pain, bowel bladder complaints are the contributory factors to decide the need for surgery.MRI is not the only criteria for surgery.So, you need to tell me more about the patient before I can make a comment on the need for surgery.Besides, you can always meet another spine surgeon and get a second opinion.Meanwhile, you can get a prescription for pregabalin, and methylcobalamin. Make sure that the patient takes rest and does not bend or lift heavy weights.Physiotherapy will have to wait till I know more about the patient, unless the doctors who have seen her there do recommend it.I have tried to make it as simple as possible.Please add the information requested so I may be able to help you further.Best of luck, Dr Mittal