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While the patient has PSIS tendonitis, their main pain generator is likely the L2-3 and L4-5 levels where there is adjacent level degeneration with scoliosis. This has been confirmed with positive responses to facet blocks and radio frequency ablations at these levels (plus L5-S1, however L5-S1 has little in the way of facet arthropathy, the disc is in good condition and there is no alignment abnormality. Diagnosis: L2-3, L4-5 adjacent level degeneration with scoliosis. Operation: Left L2-3, L4-5 Minimally Invasive Transformational Lumbar Inter body Fusion with Removal of L3-4 Hardware with L2-5 Instrumentation, with Possible Cement Augmentation Learn about LESS and other State-of-the-Art Minimally Invasive Spine Surgery at www.excelspine.com Contact us at https://excelspine.com/contact/ or (619) 344-6918 Follow me on social media: https://linktr.ee/drchollkim Subscribe to my weekly emails: http://eepurl.com/hsKXO5 Medical Disclaimer The information in this video is not intended to serve as professional medical advice, diagnosis, or treatment. To address your specific medical concerns, we strongly recommend that you consult with your healthcare provider. The surgical procedures shown in this video are performed by a qualified spine surgeon and may not be appropriate for all individuals.