Patient Information Resources Long Island Spine Specialists, P.C. 763 Larkfield Road 2nd Floor Commack, NY 11725 Ph: (631) 462-2225 Fax: (631) 462-2240

INFORMATION ABOUT: Child Orthopedics General Pain Management Spine - Cervical Spine - General Spine - Lumbar Spine - Thoracic OUR PROVIDERS: -- Select Provider -- Dr. Sushil K. Basra Dr. Hargovind DeWal, M.D. Dr. Thomas J. Dowling Dr. Christopher D. Frendo Dr. Laurence E. Mermelstein Copyright Statement Patient Education Disclaimer		« Back I was just diagnosed with my second lumbar disc herniation. The first one was at L45. This one is higher up around L23. I was able to see a physical therapist for the first one and avoid surgery. What are the chances I can do that again with this one? The Spine Patient Outcomes Research Trial (SPORT) may have some information to shed on this topic. A group of researchers from Dartmouth Medical School used the data from this multicenter study to compare outcomes of treatment based on the level of herniation. They reviewed the charts of patients with a known disc herniation at three separate levels: L2-3, L45, and L5-S1. They found that herniation location and level did make a difference in treatment results. This may have to do with the amount of space in the spinal canal as the spinal cord moves down the spine. The diameter of the spinal canal is smaller at the upper levels. Surgery to remove the disc in the upper lumbar spine seems to have a greater treatment effect than for lower levels. The direction of the herniation may also make a difference. Discs in the upper lumbar spine are more likely to protrude to the side close to the spinal nerves. It may be easier to remove the disc in this location compared to lower lumbar disc herniation, which is more likely to occur in the posterolateral (back and to the side) direction. Nonoperative (conservative) care is always advised before considering surgery. The main exception to this guideline is if you are experiencing considerable muscle weakness (or paralysis). This would indicate more severe (and possibly permanent) damage to the spinal cord or spinal nerves. In such cases, surgery to take the pressure off the neural tissue is advised. References: « Back *Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission.