Sub-ligamentous L5-S1 Extrusion with Left Sub-articular Space Compromise; Moderate Left S1 Radiculitis (CR – 20)


There is no doubt that conservative treatment of bio-mechanical disorders should be considered as the first line of treatment option, if the clinical presentation allows. 

It should be emphasized that the presence of IVD structural pathology is not necessary a progressive condition. It can in fact be treated successfully, and managed in the long term, with an acceptable prognosis. 

This case report describes the treatment protocol of a subacute moderate left S1 radiculitis due to a central left sub-ligamentous extrusion, unresponsive to other more common conservative treatment procedures. Emphasize has been made on the discopathy of cephalic segments with degenerative retrolisthesis at these levels. Further complications with a transitional segment, and a structural retrolisthesis of L5, requiring a dynamic treatment protocol.

As such, reference has been made to the Flexion/Distraction unit as an instrument, oppose to a modality. And specific parameters as applicable to this particular case were discussed.

Comparative advanced imaging study correlating the clinical and functional improvement has also been documented.

Further reference has been made to stabilization of the involved segment, and the long term prognosis in view of the complicating bio-mechanical findings.