Alif before pic A 29 year old female came to see me recently. She had developed severe lower back pain after lifting. The pain radiated into her buttocks, thighs and hamstrings preventing her from returning to work and affecting her activities of daily living.

An MRI scan demonstrated discogenic deterioration at L5/S1 with a central disc bulge and reduced space for nerves (as per image left).

Non-operative measures including rest, analgesic medication, physiotherapy, facet joint injections and an epidural injection were used to initially treat the pain but the symptoms failed to respond.

Alif after picA L5/S1 discogram (injection into the disc) verified the disc as the source of pain generation.

Surgery was performed involving an anterior lumbar interbody fusion. This resolved the patient’s symptoms and allowed her to return to her pre-injury activities without restriction.