L5-S1 Disc Degeneration


Disk degeneration is a ubiquitous process found in almost everyone by the seventh decade. Fortunately, the majority of patients have either no symptoms or symptoms that are mild or resolve with time. The small proportion of patients with symptoms related to disk degeneration, however, make up a significant proportion of those seeking care in the spine surgeon's office. Management of the symptoms should begin with a focused history and physical examination. Nonoperative management is the mainstay for most degenerative conditions of the lumbar spine. Surgical therapy for degenerative conditions of the lumbar spine should be well designed to address the underlying pathology and meet the goals of the surgeon and patient.

This article reviews the pathophysiology and clinical presentaion of L5-S1 disc degeneration, as well as surgical and nonsurgical treament options. Three surgical techniques are reviewed in detail, including anterior lumbar interbody fusion, posterior lumbar interbody fusion, and transforaminal lumbar interbody fusion. Video is available.

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