Board Certified Neurosurgeon Brain & Spine Care 860-889-9035
Mark Hornyak, MDBoard Certified Neurosurgeon
Back to Cases

Degenerative / Spine Case

Lumbar Disc Herniation

48 year-old woman presenting with back and right leg pain Pain worsening despite conservative management Back and leg both 9/10 Leg pain goes to bottom of foot Has numbness of her foot on exam and some weakness of her ankle.

Description

48 year-old woman presenting with back and right leg pain
Pain worsening despite conservative management
Back and leg both 9/10
Leg pain goes to bottom of foot
Has numbness of her foot on exam and some weakness of her ankle.

Gallery

Images

Figure 1Preliminary lumbar spine x-ray showing mold degeneration at L5/S1
Figure 2MRI lumbar spine. Sagittal image (left) shows disc herniation at L5/S1 level. Axial images (right) show disc herniation causing compression of the nerves within the spinal canal. The red arrow in the top image is pointing to the nerves within the spine. The bottom two images show the large disc herniation (white arrow) , notice that the nerves cannot be seen.
Figure 3An intraoperative x-ray images acquired from the fluoroscope. It shows surgical instruments (red arrow) approaching the L5/S1 disc space (white arrow).
Figure 4Diagram illustrating the bone removal (eg. Hemilaminectomy) and the trajectory used to expose the disc space (red arrow).
Figure 5Intraoperative photo taken using the surgical microscope. The hemilaminectomy has been performed and the dura is exposed. The disc is protruding upward – toward the viewer-(blue arrow) and the compressed dura above it.
Figure 6: Intraoperative photo after the disc has been removed
Figure 7A photograph showing the large disc fragment that has been removed from the spinal canal. It measures approximately 4cm (1 3/8 inches) .

Information on this site should not be relied upon to make a medical diagnosis or determine treatment for a medical condition. Case examples are educational and de-identified. They do not represent expected outcomes for any individual patient. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.