Jason is a 43-year-old male who is a software engineer. He presented with a 4-month history of severe low back pain that would radiate into his right buttock and down the back of his right leg. He also had pain and numbness on the bottom of his right foot. The numbness in his right foot was constant. His back, buttock, and leg pain were worse with standing, sitting, as well as flexion/extension of his spine. He described his pain as a stabbing “knife-like” pain that was increasing in severity. He denied any inciting event or trauma prior to his symptoms. He had modified his activity without a significant reduction in his symptoms. He had tried NSAIDs (e.g., Aleve), chiropractic care, massage, heat/ice, and physical therapy without significant long-term relief. He was particularly concerned since his symptoms were progressive and he was unable to sleep for more than 2 hours at a time.

Physical Exam

On exam, Jason had numbness on the bottom of his right foot. He also had increased leg pain when his right leg was extended while he was in a seated position (positive straight leg raise). He had weakness with testing of his right calf muscles (4/5 strength). In addition, he had difficulty walking on his right toes.

Diagnostic Tests

X-rays showed normal disc heights in his lumbar spine except for mild loss of disc height at L5-S1 from degeneration. His MRI showed a large disc herniation on the right at L5-S1 which was compressing his right S1 nerve.

Step 5:


The patient had tried NSAIDs (e.g., Aleve), chiropractic care, massage, heat/ice, and physical therapy without significant long-term relief. We had a long discussion in clinic regarding his options including surgery versus an injection. He elected to undergo an epidural steroid injection (a mix of local anesthesia and steroids) in his spine to see if this would help his pain. He was referred to a local physician who specializes in non-operative spinal care including injections. Unfortunately, the epidural steroid injection did not give him long-term relief. His symptoms continued to progress. He ultimately elected to proceed with a minimally invasive right L5-S1 microdiscectomy.


Surgery went well and took less than one hour. He was discharged to home from the surgery center less than one hour after his procedure was completed. His pain was significantly better immediately following surgery. He was able to return to work (software engineer) in a few days. When he was seen in clinic 2 weeks after surgery his symptoms were over 90% improved compared to before surgery. He had some residual numbness in his right leg as well as “tightness.” He denied any significant pain in his back or leg. 6 weeks following surgery his symptoms were completely resolved. He was given a prescription for physical therapy at his 6 week post-op visit to work on stretching, strengthening, and a general aerobic exercise program. At 3 months post-op he was released to full activities without restrictions including jogging.

“Dr. Addison Stone is the best of the best, and I highly recommend him to anyone seeking a back surgeon. He specializes in minimally invasive work, and does a great job – I hear the insurance companies like him because of his uber low complication rate. I had serious problems with thickened ligaments, bone spurs, herniation, and trapped nerves and Dr. Stone completed the work like a champion. I have relief from my pain, can sleep on my back for the first time in over a decade-thanks Dr. Stone!”

Tom, Healthgrades (October 03, 2017)

“Dr. Stone and his team are miracle workers! My cervical spinal cord was rapidly becoming compressed, leading to total numbness in hands, loss of control in arms and legs. He was able to schedule me right away for surgery, a fusion of 3 levels, 3-6. Recovery and reversal of symptoms has been speedy. He is an excellent and knowledgeable surgeon, and is nice and really listens to you. I highly recommend him!”

Nancy, Healthgrades (November 28, 2017)

“I don’t typically write reviews… but when your health and well-being is impacted so dramatically I feel it’s important. For over a year and a half I suffered from lower chronic back pain. I’ll spare the details… but the pain got so debilitating that I would have to get a wheel chair to make it through the airport on business travel. Sleeping on the couch sitting up became a way of life. I’m now about 90 days post-op and I ran for the first time in 6 months, pain free today! Dr Stone performed a discectomy and lamanectory on me; my only regret was that I didn’t have the procedure done a year ago. Pain level went from a 9 to post-op 2, overnight. Within 12 hours I was back to work. I can’t say enough positive things about the entire experience. Happy to be standing straight again and thankful for a wonderful surgeon!”

Chad Mitchell, Google (May 2018)

“Have already recommended Dr Stone to someone else from my office who is calling to set an appointment.”

Bob Saunders, Healthgrades (Dec 21, 2017)