Regenerative Approach to Post‑Laminectomy L5‑S1 Pain

This 58-year-old former athlete has chronic lower back pain after an L3-L5 fusion, with post-laminectomy syndrome, severe L5-S1 disc degeneration, facet joint arthropathy, and nerve inflammation radiating to the right hip and glute. We began with an interlaminar L5-S1 injection to confirm epidural contrast flow, then performed a transforaminal L5-S1 nerve root injection to ensure optimal contrast spread around the nerve and epidural space. A targeted combination of regenerative products, growth factors, and peptides was delivered directly to the affected epidural and perineural regions to address inflammation and support tissue repair. Because the prior fusion increases stress on L5-S1, we also treated the bilateral L5-S1 facet joints. The upper spine above the fusion is showing significant tension and will be addressed in Part 2.