### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hola! I had a lumbar spine MRI and was told my L5 transverse process is articulated with the sacrum. This is obviously what has been causing me low back ache (and other aches and pains) since I was a teenager. More recently (since pregnancy over 5 years ago) I also have a more localised pain which turns out to be the exact location of where the L5 TV would touch the sacrum. I am in physiotherapy for this but I really think that the results will be temporary if my pain is relieved. I think this because if I miss a couple of days of exercise, I m back to square one with the pain and ache. I really want to have the resection (transverse process) surgery. The thing is.. I really want to know if the surgery could actually give me the flexibility I never had in my back due to the Bertolottis syndrome that I ve had for so long. Mechanically it makes sense that it would, but in reality is it too much too late? I would like to hear from any surgeon who has experience the this surgery... and what is the recovery like for this op?Many thanks

### output:

Hi, thank you for providing the brief history of you. As by reading your history I can understand that the backache is bothering you too much. As in my clinical experience I see cases with such abnormalities of spine. I personally have recommended people not tonunderfo surgery to the importance of the muscles and the bony factors. Performing regular exercises will surely help you proceed further. The reason to avoid the surgery is also the recurrent post surgical pain. As the spine will be more of the instable. Usually, post laminectomy, discectomy, etc. any spinal surgeries the pain persists in the future. Since it is more of a joint play understanding here that the physics of the spine is designed to bear the sheer stress and load onto it. Also, once the muscles are stronger with the following exercises the levels are under control. Exercise includes - Core stability, Pelvic floor strengthening, Spine muscle strengthening, hip muscles strengthening, and later over all body conditioning. Looking forward to the other matter here is why the pain arises, it is the understanding of the just bony deformity, or it is more of the physics of mechanism involved. To head further I recommend my patients to use the hard wooden surface to sleep in nights, which the body in momentum and the recurrence of pain is much less. Practicing regular exercises post learning from a physical therapist helps in longer run. Surgery is a memory relief of pain, but post the surgery the pain and aches are more due to instability of the spine, which I have personally experienced in my clinical practice. Also, the best job of an orthopedic surgeon is to safeguard the joint and not to allow it to damage more. A good surgeon will never advise for the surgery as the original joint has its own importance which no good surgeon will have a mind to lose. I will recommend undergoing a good number of weeks of physical therapy where you will learn various ways to exercise and safeguard the spine for future and avoid surgeries. In my clinical practice I have this same attitude of teaching more of the physical exercises then looking for the surgery. As exercise is the natural form of safeguarding the spine and surgery is the artificial. So choice is left up to you. In my opinion learning the best way to exercise is better than undergoing the knife.regards. Jay In Chat Doctor. 