Herniated discs L4-5 and L5-S1
This is a 36-year-old, male, with a history of low back pain and left sciatica for many years. He is not my patient, as he lives in Maine, but he asked me to review his images and provide an opinion on his surgeon’s recommendation. He stated that his pain is probably attributed to his work, stocking at a liquor store for several years.
This gentleman told me he has tried two epidural steroid injections, chiropractic treatment, and physical therapy, none of which helped. He has seen several surgeons for surgical opinions. The surgical option he has chosen is to get a discectomy of only the worst disc, i.e. the L4-5 disc, which is a large herniation, and leave the remaining three, smaller disc herniations alone, and see how much improvement he gets. The reason for this choice is that his other option includes doing surgery on his L5-S1 herniation also, but that would require doing fusions at those same, two levels, and that is something that should be avoided if at all possible in a person so young.
Herniated discs L4-5 and L5-S1
You will see on these images that his L4-5 herniation is large, occupying much of his neural canal. But he also has a smaller, disc herniation at L5-S1, which is pinching his left S1 nerve root, and probably accounts for some of his sciatica pain. Given the undesirability of a two-level fusion at L4-5-S1, a single-level discectomy is a good choice. If he lived anywhere near me I would encourage him to try my non-surgical, spinal decompression treatment to see if he can avoid surgery. His surgeon is going to reassess his status after the discectomy, and we will see how much better he is, and how much remaining pain he has from the remaining disc herniation at L5-S1.
If I can help you with your low back or neck pain, please call me at 404-558-4015.
