Spinal Stenosis

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Aoa. My mother is DM-2 on insulin, Hypertensive, Stage 2 renal failiure (taking medicine regularly so all conditions in control). She developed pain lower back radiating to left leg since 1 month. pain sharp, localized and associated with movements. pain is relieved while sitting or resting (lying on bed ). She is taking Tablet. Gabapil 75mg BD and other pain killers advised by local General Practitioners but seems not helping much. X-ray and MRI shows narrowing of L4,L5 spaces and nerves compressed. Went to local pain clinic and Doctor recommended Laser procedures for decompressing nerves. Name of procedure is "Transforming Nerve root Procedure and Intradiscal Laser (rf) for 50,000 rupees. Can any Neurosurgeon Please comment on this treatment. We also consulted a Neurosurgeon in RYK. He says immediate decompressive surgery at multilevel is required. Should we go for surgery or wait and see while doing physiotherapy . MRI and other images are attached. Thanks in advance

dr-hammad-nasir-neuro-surgeon-lahore

Mbbs, MS (Neurosurgery) | Lahore

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Dear
There are multiple factors to consider in this case
1- spinal stenoses case usually present with history of clsudication ( stiffness in legs which increase with walk ) pain come at the end.
If ur pt is hving acute pain need dynamic view x-rays
On examinstion SLR is usually negstive
2. MRI images r showing multilevel dehydrated discs nd stenoses most marked at L4-5
As far the question of RF treatment , i hv experience of using laser in spinal diseases probably pioneer in this field in punjab.started in 042-32591427, . RF nd Laser are 2 different modalities ,
In this case in my Oinion RF not goin to giv gd relief. Dehydrated disc not goin to shrink further , only applying RF to facets my decrease the pain perception temporarily.
Better option is open surgery.
Thanks

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