As has been previously reported, lumbar disc herniation, or sciatica, is one of the most common spinal conditions confronting the general population. At some point in time, most people between the ages of 30 and 70 will experience a sciatica, in which the lumbar shock absorber, the disc, protrudes or bulges out to pinch on a nerve. This usually happens after some degree of twist, turn, or light trauma, but very often without any particular triggering event. Most of these herniations lead to a central or slightly lateral disc herniation, which will affect either one leg or the other, depending on whether it is right- or left-sided.
Every so often, though, a disc bulges or blasts out from a very far lateral standpoint, which will directly impact on either a right- or left-sided nerve in a very severe way. This is because as the disc bulges out laterally, it hits the nerve as well as the surrounding bone and membrane, which leads to a very tight surface and volume for the nerve, resulting in severe pain. In contrast to a standard lumbar disc herniation or sciatica, this will usually not respond to conservative measures such as physical therapy, medications, and/or epidural injections.
We recently had one such case of this uncommon occurrence in a 38-year-old bodybuilder who, after a particularly rigorous set of exercises over a month period, began having severe pain, numbness, and weakness into the left thigh region radiating from his back into his left knee. He came in to see us at the Center for Musculoskeletal Disorders, and had an immediate MRI ordered showing a very large L2-3 far lateral disc herniation. We attempted an epidural steroid injection to give him some relief, with the understanding that it may not give him the necessary long-term comfort and resolution
Indeed, it did reduce the symptoms, but not enough for this very active gentleman. So…earlier this month he was brought to the Bergenfield Surgical Center and, using a microscopic tubular approach and a small, 1.8 cm incision on his back, a tube was docked onto his L2-3 left lateral space and the herniated disc, using microscopic assistance, was removed. The patient left the surgery center approximately an hour and one-half after the procedure, pain reduced and the wounds healing very well!! Photos are enclosed.
Although this type of herniation is uncommon, we are seeing it with greater frequency and, therefore, if indeed you are experiencing particularly severe back pain with pain down the leg, with significant numbness and/or tingling, please do not hesitate to contact us to schedule an appointment to see either one of our pain management doctors or spinal doctor. We can help obtain the appropriate x-rays and MRI imaging, and get you back to a functional and enjoyable level!
Wishing you the best of spinal health. Please stay in touch!
CMD Spinal team