Herniated disc at L5-S1
In this video, I’ll show you another herniated disc at L5-S1, this time a very large one, and tell you when a surgical discectomy is a reasonable choice, what is the likelihood of disc resorption, and when is surgery an absolute necessity.
This patient was a female in her 40’s who had this episode of pain for about 4 months. I am just starting her on treatment, and her surgeon offered to do surgery for her. Her pain is not as bad as her disc is large, and sometimes we see that. Some people have a lot of pain with a smaller disc herniation. And others have less pain, in spite of a larger disc herniation. How we treat patients with disc herniations is a combination of the anatomical problem and their signs and symptoms. But it has most to do with their signs and symptoms than the size of the disc herniation.
In this case, it is important to explain to the patient, her options, and because her disc herniation is large, with the potential for cauda equina syndrome, i.e. compression on the nerve roots that cause bowel and bladder function, she must be well informed about the rare possibility that she might have to rush to the hospital for surgery if she experiences any bowel or bladder incontinence or retention.
I told her that I don’t want to waste her time or money, so we have to determine, ASAP, if I can help her, how much, and how quickly. So we’ll start treatment right now, do it frequently, and see how quickly I can get her better. If not, I will send her to an excellent neurosurgeon to do this very simple surgery. Sometimes surgery is the best choice, but it is never undertaken without exhausting all reasonable non-surgical methods of treatment, because it does not some greater risk than non-surgical treatment.
If I can help you, call me at 404-558-4015.
