ABSTRACT
A 47-year-old male presented for evaluation with a chief complaint of increasing mechanical low back pain as well as left leg pain for 18 months, primarily in an L5 distribution. The patient had engaged in multiple non-surgical treatments, including reduction of activity, NSAIDs, a home exercise program, 8 weeks of physical therapy, and two interlaminar L4–5 epidural steroid injections. Despite his compliance with non-surgical therapies, he became increasingly debilitated by left sciatica. His primary complaint was both back and left leg pain with walking or activity, which interfered with his occupation as a welder as well as with his previous exercise regimen of weightlifting. Although a simple minimally invasive decompression is an attractive option for patient, any treatment must consider his individual concern for long-term durability, in addition to his heavy labor occupation. In terms of discussing lumbar fusion options with the patient, minimally invasive TLIF has been demonstrated to achieve excellent long-term results as well as accelerate recovery process.
