You need to differentiate between the lower back pain (LBP) and the leg pain by percentages. That is, do you have 70% LBP and 30% leg pain, 80/20, 50/50 or????
It does look like you have scarring of the root. The root is designed to move in the spinal canal like a cable over a pulley. Certain positions (bending and flexing) will stretch the root. If this root is bound down by scar and is fixed to the canal, the stretch will pull on this root and cause it to fire (produce symptoms).
If this is the case, sometimes an epidural steroid injection can give short and even long term relief. If these symptoms continue in spite of physical therapy (gentile stretching of this root), then occasionally a neurolysis (surgically freeing the root from the scar) can be effective but it is difficult to prevent recurrence of scar formation. I have been in rare cases where the root has so much scar that is was impossible to free the nerve without possible further injury and the surgery had to be abandoned. Great care has to be practiced with these cases.
Now, if this level is causing lower back pain and for some reason needs a fusion, then the root can be freed as a fusion allows “disassembly” of this level and much surgical “room” to free the nerve root at the time of fusion.
Dr. Corenman
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.