Lumbar Disc Herniation

A lumbar disc herniation is occurs when a small piece of lumbar disc material breaks off and herniates from it’s normal location and compresses the nerve or the thecal sac. The most common areas for disc herniation are the lower two disc spaces, L4-5 and L5-S1. L4 and L5 are the superior and inferior bones with disc in between called the L4-5 disc; the same notation for L5-S1 and any other disc. If the disc herniates laterally, it will compress a nerve usually causing unilateral leg pain; if the disc herniates centrally, it causes back and sometimes bilateral leg pain. When there is a disc herniation at L4-5 to one side or the other, a patient can develop a foot drop from compression of the L5 nerve root. A foot drop occurs when you lose the ability lift your foot up while taking a step and the foot then drags as you walk. An L4-5 disc herniation can cause severe leg pain starting in the buttock radiating to the top of the foot with or without a foot drop. An L5-S1 herniation can cause severe leg pain starting in the buttock radiating to the bottom of the foot with or without weakness when stepping down. A herniated disc at L3-4 will cause thigh pain and a herniated disk at L2-3 will cause groin pain. Most symptomatic disc herniations resolve on their own, over time. It is estimated that only 10 – 15% of patients who present with a symptomatic disc herniation will need surgery.

Treatment

Non-operative. The initial course of treatment after the diagnosis has been made is oral steroids for seven days, rest and non-steroidal anti-inflammatory agents for pain. Once the pain has lessened, you may be referred for a course of Physical Therapy. Other options include an epidural injection to help with the pain.

Surgery. Patients are referred to a surgeon if there is persistent weakness that does not improve after 8 –12 weeks or the pain is intolerable. Surgery includes a Microdiskectomy where the disc fragment is removed through a small incision (1.5 inches), takes approximately 45 minutes, and patients go home the same day.

Lumbar Disc Herniation Causing Lumbar Radiculopathy​

​40-year-old lawyer with severe left leg pain due to a disc herniation at L4-5, Left. He failed conservative care after 12 weeks and then opted for surgery.​

MRI Lumbar Spine shows disc herniation with yellow arrows.​​

Patient underwent diskectomy and with complete relief of pain.​

Meet the Team

Two Surgeon Model

Your surgery is performed by both a Neurosurgeon and Orthopedic Spine Surgeon for optimal safety and outcome. The Neurosurgeons will approach the spine and decompress the nerves and spine cord while the Orthopedic Surgeon will perform the fusion. Each surgeon is there during the entire surgery assisting the other with their particular part. Having two surgeons decreases the chances of any errors or problems and decreases the length of surgery.

The Lumbar Spine Center is dedicated to the treatment and outcomes of patients who suffer from problems related to the lumbar spine. Our program is focused on high quality clinical outcomes and the most effective treatments for all conditions related to the lumbar spine. To learn more, schedule a consultation at one of our two locations.

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    Excellent
    Based on 74 reviews
    Angelo Troiano
    Angelo Troiano
    November 14, 2022
    Very professional and thorough with my surgery.
    Faith Schwenker
    Faith Schwenker
    March 22, 2022
    Dr. Abraham’s did my surgery and it was a great success. After nearly 8 years of pain, I finally found a doctor who could help me. My sciatica nerve was compressing my L4 and L5 which was giving me pain and a very poor quality of life. Not only does Dr. Abraham’s have a great bedside manner, but also he certainly knows the complexities of the spine. Thank you so much for giving me my life back!! P.S. I have referred his name to several of my friends and they too have had a successful outcome!!
    Kathleen Cully
    Kathleen Cully
    May 28, 2021
    Dr. Abrahams is an extremely compassionate and highly skilled neurosurgeon who, along with Dr. C. Shannon, saved my husband's life by removing a complicated malignant metastatic brain tumor during a very long surgery. In addition, Dr. Abrahams has been my surgeon for several spinal procedures and I trust him with my life.
    Kathleen Darcy
    Kathleen Darcy
    February 22, 2021
    My experience was great 😊. Dr Abraham was fabulous.
    Xavier Masi
    Xavier Masi
    February 15, 2021
    Dr. Abrahams is the best, very caring and takes time out to listen instead of rushing!!! thanks Doc.. I might have to come see you again. Anthony
    Dale
    Dale
    February 15, 2021
    😷 Dr Abrahams is THE BEST! He is the absolute best brain & spine surgeon by far! His group is beyond excellent! My back & neck had been fractured in an accident, and I made the mistake of seeing a "spine doctor on Tarrytown Road," who did not want to see me again unless I needed more surgery! I was outright denied an appointment, even after this "doctor" performed a lumbar laminectomy on me!!!😡 I was miserable and in excruciating pain. Then everything changed.... 🙏THANK GOD I FOUND DR ABRAHAMS! He took all the time he needed with me to come up with a new plan and thoroughly explained the correct surgery I needed. I had a fractured sacrum, lower back S1, right up to L5, needing spinal fusion. I also had cervical herniations. My life changed after Dr Abrahams took care of my surgery, his office still checks up on me to make sure I'm doing well. The office and entire staff is so helpful, friendly and caring. I recommend Dr Abrahams on a regular basis to people I meet that have brain or spine problems. Dr Abrahams is also BRILLIANT. He is the creator of many medical devices that he received patents for. When you go in his office your eyes won't know what to look at first he has so many awards & patents. He's a MUST GO TO doctor! He changed my life, and I am forever grateful to him, Lisa (his personal coordinator), and his entire staff, fellow doctors that are also in group with Dr Abrahams. I HIGHLY RECOMMEND HIM as well as the doctors in practice within his group. You will get the best care by far.😊
    Helena Mattis
    Helena Mattis
    January 12, 2021
    Dr. Abrahams literally saved my life. I went to him back in 2004 in horrible shape after being misdiagnosed by my Primary Care Physician. He went above and beyond in saving my life. I highly recommend him for his skills, ability, his humanity and love he demonstrates for both his patients and his work. Helena Edwards
    Farah Rubeo
    Farah Rubeo
    September 13, 2020
    Dr. Abrahams performed back surgery on me 6 years ago . I was 38 yrs old and in excruciating pain, not able to walk for longer longer than 5 minutes, sleeplessness nights and constantly being put on pain medication , including countless rounds of PT. Surgery was my only option to return to the quality of life I had before my injury and I am beyond grateful for Dr. Abrahams and his team. I have been playing softball, exercising , walking my dog and enjoying everything that I have missed for years! Dr. Abrahams to me Is a lifesaver! The best of the best !