Procedure of the Month

You Chose Selection #2:
Decompression and interbody fusion L5-S1 only

Again, not the best treatment option. First, the majority of our patient’s discomfort is radicular pain (90%), not mechanical back pain (10%). Since the majority of her symptoms appear to be originating from the S1 nerve root, a decompression is indicated. There is, however, no clear indications for interbody fusion. Second, our patient has degeneration at L4-5 as well as L5-S1 which may be the source of some of her back pain. Therefore, if fusion surgery is considered, a discogram may be useful in order to evaluate whether the disc at L4-5 is the pain generator. Third, given her young age (26 years), fusion surgery should be delayed for as long as possible since it may put her at risk for accelerated degeneration of her adjacent disc. Finally, if our patient continues to have increasing back pain after decompression alone, she would still be a potential candidate for interbody fusion if indicated.

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