Question
QUESTION: Hi, I have a disc. hern. at L5-S1. There is a "disc fragment that has migrated superiorly a small distane above the L5-S1 disc space. Encroach upon the right neural foramina at this level."  Will the fragment just dissipate??

ANSWER: Hi K,

Yes it will and if you can tolerate it, do not have it cut out. This will cause inevitable scar tissue formation in and around the nerve root creating more problems than before. Reduce the herniation after resorption of the fragment, approximately one year or less depending on size, and get back to me on non-surgically reducing that herniation. No need for surgery there either. There is a good reason why you don't want to address that now since the fragment can shift during therapy and cause excruciating pain unnecessarily. Wait till it gets small and goes away then get the herniation decompressed. Reading past questions from myself will explain the procedure incase you can't wait.:)

Good Luck!

Dr. Timothy Durnin

---------- FOLLOW-UP ----------

QUESTION: Thanks for your advice.  But how do I know how large the piece is? The MRI doesn't say.  Can I contact them and ask what size?  I was planning on P.T. right away, but understand what you're saying.  I will definitely read your advice on decompression, since I'm otherwise healthy and want to avoid surgery.  I love your line of thinking!

Answer
Thanks K, I appreciate,
They should fax or mail you the report, it should say. No to physical therapy due to the risk of moving the fragment. Wait a while, then go the F/D route. PT rarely if ever works for herniated discs, don't waste your time.

Good Luck!

Dr. Tim