The films
Where in the spine
Cervical
C1
C7
Thoracic
T1
T12
Lumbar
L1
L5
◀ herniation removed (microdiscectomy)
Sacrum & pelvis
S1
Same level as C-02 — a different road.
The herniated L5-S1 fragment kept pressing on the leg’s nerve root after three full months of conservative care. A microdiscectomy removes just the fragment through a small incision — the disc, the level, and its motion all stay.
L5-S1 herniation — fragment removed, level left mobile
The course, in order
- Day 0Lifting injuryShoveling stone at work; severe back and leg pain.
- Months 0–3Full conservative trialPhysical therapy, medications, and injections — each given a real chance.
- The decisionLeg pain persistedPast a full conservative course, surgery earns its place.
- SurgeryL5-S1 microdiscectomySmall incision; herniated fragment removed, nerve decompressed.
- AfterBuilt for leg-pain reliefDecompressing the root is what settles the leg symptoms.
Presentation
Work-related lifting injury shoveling stone; severe back and leg pain without weakness.
Imaging
Sagittal MRI shows the L5-S1 herniation at the arrow.
Decision
Physical therapy, medications, and injections were each given a real trial — more than three months. When leg pain persists past a full conservative course, surgery earns its place.
What was done
L5-S1 microdiscectomy — a small-incision operation that removes the herniated fragment and decompresses the nerve.
Full conservative trial firstSmall-incision surgeryBuilt for leg-pain relief
"Surgery came third — after therapy and injections had their chance."
All cases shown are real patients treated by Dr. Andrew Pugely, presented with de-identified imaging for education. Every spine — and every recovery — is different: individual results vary, and nothing on this page is a guarantee of outcome or a substitute for an in-person evaluation.
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