Procedure of the Month

On this page are two images of a patient’s lumbar spine. This patient presented with chronic low back pain (3/10), with acute onset of right lower extremity pain (5/10). A physical exam showed weakness (4/5) of Rt. Extensor Halitus Longus, otherwise normal. X-ray images show Degenerative Disc Disease (DDD) at L4/5.

Pre-op images - AP and Lateral View

MRI confirmed DDD at L4/5 with mild arthritic changes in the facet joint, but also revealed Rt. Paracentral HNP at L4/5. Discogram indicated concordant pain at L4/5. The patient failed all documented conservative treatment programs.

Which of the following choices do you think best describes the patient’s treatment options?

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