9th June 2021

A 58-year-old man presents with a two-week history of lower back pain

A 58-year-old man presents with a two-week history of lower back pain, which has acutely worsened over the past day, rendering him immobile. He is unable to pass urine, with a bladder scan demonstrating 700ml in his bladder, and on rectal examination has a loss of perianal sensation and reduced anal tone. An MRI is done, which shows cauda equina syndrome secondary to disc prolapse. He is referred to the neurosurgery team, who arrange for an urgent transfer.

Which of the following is the preferred first-line surgery to treat this condition? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.