The patient retired minister came to the clinic 24-May-2006 complaining of
LBP for 6 years with bilateral sciatica more the left for 6 months. The condition
deteriorating and he was limping. MRI performed 04-April-2006 showing huge extrusion of
L4-5 with wide base more in the left in the disc level with
contralateral downward migration.
On examination: SLRS was 30
degrees in both sides with weak dorsiflexion both feet. He is
a known hypertensive and cath done 8 and 6 years ago and in
L-thyroxin 150 microgram daily after throidectomy for goiter 2
years ago. He was
advised to undergo surgery and given pain-killers.
Bilateral L4-5 flavotomy with right L5 root foraminotomy was done
and the extruded disc was removed in one piece from the left side lateral
to the axilla. Bilateral cleaning of the disc space of L4-5 was
performed and meticulous cleaning was done. The right L5 root was
inspected for remnants of extrusion, which turned to be negative.
Routine closure of the wound. Smooth postoperative neurological