A 26 years old women without medical history presented left leg pain after lifting a heavy object. She can’t stand up because of the sciatic pain, and also complained with numbness of the bottom of left foot. Straight-leg-Raising test showed only 30 degree, and MRI (Magnetic resonance imaging) showed a huge L5-S1 disc herniation, and nerve root was compressed (A and B, arrow). Conservative treatment with rest on bed with lumbar traction, combined with nonsteroidal anti-inflammatory medicine. She had a good compliance at first four weeks. Then, she back to work with mild sciatic pain, and come to outpatient clinic one year after first interview, she said without leg pain now and free to normal work life. The MRI of one year follow up showed the previous huge L5-S1 disc herniation was disappeared (C and D, arrow). Current trials found that surgery may be had an earlier relief of pain, however, few differences were observed in pain and disability between surgical and conservative treatment after one year. Additionally, conservative treatment have advantage of cost saving.

DISCLOSE AND ACKNOWLEDGEMENT

FDA device/drug status: Not applicable.

Author disclosures: AM Wu: Nothing to disclose. FM M: Nothing to disclose. XYW: Nothing to disclose. YL Chi: Nothing to disclose. WF Ni: Nothing to disclose.

This work was partly supported by the National Natural Science Foundation of China (81501933 AMW, 81372014 YLC).