Percutaneous Disc Decompression at L5-S1

Submitted by Rainier Guiang, M.D.

Disc Decompression at the level of L5-S1 is the most difficult level to access in the lumbar spine. Visualization using the oblique approach requires extreme cephalad tilt of the fluoroscope. In our example, the cephalad tilt was practically touching the patient's back!.

AP view showing the introducer needle in the lateral 1/3 of the disc between L5 and S1.

Lateral view showing the introducer in the posterior 1/3 of the disc at L5-S1.