Conversation: The conversation between human and AI assistant.
[|Human|] Hi I am a 31 year old female and have had chronic back pain now for 2 years, I had a Mri scan in november which gave the following results - consis L1 normal, dehydration of the two lower lumber discs is noted. disk protrusion L4/5 and L5/s1. central disc bulging noted L4/5 indenting the theca. loss of lordosis. Have had a course of physiotherapy and accupunture, gp thinks either spinal injections or surgery best way forward, though none of these findings have really been explained to myself
[|AI|]  Surgical removal of disc (discectomy) and fusion are done if no response after epidural injections, physical therapy, radiation of pain limiting movement, bending and interfering with normal activity, not responding to medications. Subjectively, you may summarize your syptomsand its relation t following-- 1. Whether you can bend easily.2.does coughing/sneezing accelerates pain locally. 3. can you lift objects from ground?. 4.is the pain continuously there or comes on movement? 5. is your daily work, occupation hampered? If all these are positive then surgery is a solution. Some spine surgeons do laparoscopic removal of disc through a minute hole, while others do open surgery especially if fusion of adjacent vertebrae is necessary in view of foraminal pathology, nerve compression and rotatory spine movement bring on radiation of pain to lower limbs or to severity of back pain. Epidurals are tried for remission of pains if surgery is not yet possible/or indicated and normal daily activity is not Chat Doctor. I hope this solves your question