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26-JUNE-2010 AMEEN HAFEZ MUHAMED 38 YEARS
HUGE BILATERAL EXTRUDED DISC L4-5 MORE TO THE RIGHT.
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to the clinic 23-June-2010 complaining of LBP
for 10 years which disappeared, then the last 2
months got agonizing left sciatica and bilateral
sciatica the last month more the right.
On examination: the
patient is limping with scoliotic stance. SLRS was
5 degrees with
pain both sides with weak dorsiflexion right
foot 3/5 and planterflexion 3/5.
MRI lumbar spine done
24-June-2010 showing huge extruded disc L4-5
with bilateral extrusion more to the right with
sacralization of L5.
Using image-intensifier the L4-5 level was
confirmed and bilateral flavotomy of L4-5 was
done and bilateral removal of the extruded disc,
starting from the right then from the left,
after what the roots became lax. Bilateral
cleaning of the disc space of L4-5.
Routine closure of the wound and smooth postoperative recovery with
improvement of the power of right foot.
The patient had very huge
disc with agonizing pain. The neurological
deficit was accompanied with the huge extrusion
in the right.
The expected postoperative
recurrence is below 7%, because the disc space
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .