### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello good evening. My name is Robert. I have a previous history of TLIF spinal fusion L5-S1 in 2011. I was involved in an auto accident in 6/11/13 while at work. I was struck from behind by a Frito Lay delivery truck and a sedan. I went to the ER, and was referred for Neuro Surgery. Neuro surgeon referred me to a neurologist who conducted EMG / NCV which indicated Chornic Bilateral Radiuclaphty.  I requested Lumbar MRI which reported small central disk bulge at L5-S1 area, and Cervical MRI which indicated C4-C5 of a small subligamentous disk hernation at left ventral touching cord. I have felt moderate to severe pain for almost 5 months. I am scheduled to see a Neuro Surgeon in 2 weeks. I had previous bad experience with pain management, and I am wondering if I should reconsider having surgery again for the back and most likely neck. Any feedback is greatly appreciated. I do have a workers comp & third party attorney working on case recently.Thanks

### output:

Hello Mr Robert, you mentioned that EMG/NCV studies indicated chronic bilateral radiculopathy. Is this report for upper or lower limbs? If it is for lower limbs, with your previous history of TGIF fusion for L5-S1 and present MRI showing small central disc bulge at the same region you need not worry about this as it is already a pre-existing problem. Do you have such a severe neck pain n articular pain in both hands incapacitating your daily activities now ? Do u have any difficulty in gripping things with hands or do u have any difficulty in combing your hair or buttoning n unbuttoning of shirt? If u don't have any of the above-mentioned, small ligamentous disc herniation at C4-C5 region, I always advise you conservative treatment in the form of wearing a hard cervical collar when u r at work, analgesics like tab diclofenac 100 mg twice daily after food, one tablet pantoprazole 40 mg on empty stomach in the morning half an hour before breakfast, a pregabalin tablet 75 mg per day and physiotherapy (IT) n one week of bed rest is advisable.