This is not an uncommon presentation for patients with previous successful discectomies who years later develop chronic pain unresponsive to conservative care. They, in my opinion, are the best patients for fusion or disc replacement (provided they have no contraindications). With the advent of rh-Bone Morphogenetic Protein-2 (BMP) and percutaneous screws, these patients undergo surgery much faster with much less postoperative pain and an extremely high fusion rate. They also recover and return to activities much faster as this case illustrates. This is in marked contrast to fusions done years ago when it took 6 months or more for a fusion to heal. With anterior posterior constructs patients are stable immediately. In general, we do not carry out posterior decompressions and just utilize MIS pedicle screws.
Conservative Treatment of Lower Back Pain When to Have Neck Surgery When to have Lower Back Surgery Neck and Back Pain Medications Spinal Cord and Peripheral Nerve Stimulation Treatment: Diagnostic Cervical Discograms Lumbar Discograms EMG/NCV- Electromyograms and Nerve Conduction Studies Epidural Injections and Selective Nerve Root Blocks- Diagnostic and Therapeutic Facet Blocks and Rhizotomies Pain Diary Instructions for Spinal Injections Treatment: Surgical Lumbar Microdiscectomy Transforaminal Lumbar Interbody Fusion (TLIF) Anterior Cervical Decompression & Fusion (ACDF) Laminotomy Lumbar Fusion Types Failed Spine Surgery Correction Cervical Laminectomy, Laminoplasty and Posterior Cervical Fusion Scoliosis Surgery Posterior Cervical Decompression and Posterior Cervical Foramenotomy Artificial Disc Replacement (ADR) for Cervical Spine Artificial Disc Replacement (ADR) for Lumbar Spine Surgical Repair of Pars Interarticularis Fractures Without Degenerative Disc Changes
Do you have pain in your lower back? If you are older or engage in strenuous activity, it could be caused by a protruding disc, also known as a herniated, slipped, or bulging disc. The L5 S1 disc in particular is the most fragile and susceptible to protrusion since it often carries more weight than the other lumbar discs. ((L5 is medical shorthand for the fifth vertebrae in the lumbar, or the lower part of the spine, and S1 denotes the first vertebrae in the sacrum. The L5 S1 disc is sandwiched between these two vertebrae). A protrusion is the most common cause of lower back pain.