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08-JULY-2013
ABDALLA HMEID MUHAMED MDAES 60 YEARS EXTRUDED DISC L5-S1 WITH LEFT
FORAMINAL AND EXTRAFORAMINAL MIGRATION.
Anamnesis
The patient came to the clinic 06-July-2013
complaining of left
sciatica sciatica for 15 days down to the big
toe left foot with positive cough sign.
MRI lumbar done in Yemen bad quality 27-June-2013 showed
extruded disci L2-3, L3-4, L4-5 and L5-S1.
On examination: the patient is limping with
exaggerated scoliotic stance with SLRS 90
degrees with pain in the left. Weak
dorsiflexion left foot 2/5 and planterflexion
same foot 4/5. There is dyseasthesia left left
L5 and S1 territories.
MRI repeated 07-July-2013 showing lumbar canal
stenosis L2-3, L3-4 and L4-5 with extruded disc
L5-S1 with left foraminal occlusion and left
extraforaminal extension.
Laminectomy L5 with
foraminotomy left L5 and S1 roots. The extruded
disc of L5-S1 was removed lateral to the axilla
of S1 root. Left sided cleaning L5-S1 disc
space. The extruded extraforaminal part was
removed and the left L5 root was followed down
to be seen at the L5-S1 annulus fibrosis level.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
left foot became normal with regression of the
left sciatica.
Comments
The patient has several problems, some of them
are old and others are recent. Dealing with the
recent problem is the wise decision.
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