A 48 year old machinery operator presented with Right L5 radiculopathy for over 1 year. He has had left L5/S1 discectomy in 2006 with good results and a repeat discectomy in 2018. However the new right sided symptoms were investigated by several spine surgeons and he had no improvement with non- operative treatment including physiotherapy, pain medications and cortisone injections.

His scans revealed MODIC changes at L5/S1 with right foraminal narrowing . He also had positive bone scan at that level. As symptoms were severe and he was off work for a year an Anterior Lumbar interbody fusion was performed with percutaneous pedicle screws and minimally invasive decompression and fusion. Patient was in hospital for 7 days and was mobile from Day 1 post surgery. He returned back to light duties at 3 months and full term duties at 6 months. Outcome scores had all improved – Oswestry Disability Index to 10% ( Minimal disability), RMDQ( Rolland Morris Disability Questionnaire) to 1/24 and overall health to 95%. Appropriate investigations and treatment for lumbar spondylosis can result in great recovery.

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Dr Prashanth J Rao
Neurosurgeon and Spine Surgeon