A 20 years old girl was in the middle of her college degree final examinations when she started having severe radiating pain in her left leg. She had to sit for this exam just 2 days away and missing that was not an option she would consider. But this sudden onset severe radiating pain in her leg wouldn’t allow her to sit for even five minutes. She also had some tingling sensation and some numbness in part of the left foot and leg. She had a prior history of low back pain and was diagnosed to have an L4-L5 disc bulge one year ago but was free of symptoms after treatment till this episode.

She came to see me in this condition in our spine clinic just 48 hours before the important exam. After a clinical examination it was obvious we needed a MRI of the lumbar spine as it looked like a disc prolapse causing severe nerve root compression. An MRI of the lumbosacral spine was done immediately and she had disc prolapse at two levels causing severe nerve root compression and that was the reason for her symptoms. She was explained about the problem and given the option of bed rest and medications or a root block injection. But she wasn’t willing to give up the examination for which she had prepared putting in a lot of hard work.

She insisted on a more definitive treatment for her leg pain. She was advised to undergo an endoscopic discectomy and the pros and cons were explained. She consented for the procedure and it a two level interlaminar endoscopic discectomy using Destandu endoscope was done at L4/5 and L5/S1 levels the same evening. She recovered well and was able to walk without leg pain and was able to sit comfortably for over half an hour by next morning. She was discharged from the hospital the next evening after surgery.