Mr X 38/M came with severe back and leg pain radiating from low back to the leg on left side for almost 5months. He had a similar episodes for which he underwent discectomy procedure in some other place. He was investigated with MRI and was found to have recurrent disc prolapse at L4-5, Sacralised L5 and with Modic changes. Considering his third time recurrence and Modic changes we planned for L4-5 TLIF procedure and was operated with the same, to prevent further recurrences. Post surgery he was made to walk on the same day and went home on 3rd day. Currently he is 2years post surgery and he is able to do all activities of daily living like sitting down, bending down, climbing stairs, driving bike, lifting weights etc.,
Key points :
1. The primary reason for Recurrent disc prolapse is the inherent nature of the disc. If the disc is degenerated, it will never revert to normalcy and if back care is not considered, even after surgery there are chances of recurrence.
2. Getting microscopic Discectomy from trained hands who are Specialised and doing exclusively spine surgery rather than general Orthopedics surgeons and neurosurgeons can reduce further chances of recurrence
3. Fusion surgery for such scenario can completely cure the problem and is recommended if there are multiple recurrences
