<s>[INST] Hello there, I recently had an MRI that showed l4-l5 diffuse disc bulge with indentation of the thecal sac and bilater lateral recess narrowing..I had a fusion with hardware in Jan. 2008...I have had pain even after the surgery..I think I will need another surgery..What would be your impression? [/INST] Hello, Diffuse disc bulge is not an indication of surgery until unless disc is compressing severely over the nerves. If you already had previous surgery then you should follow proper back precautions. Avoid bending at back and lifting heavy weights. Taking help from a physiotherapist will be more helpful in your case. Hope I have answered your query. Let me know if I can assist you further. Take care  </s>