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29-JANUARY-2003 ALI
MUHAMED ALI AL-HAJJY 33 YEARS EXTRUDED DISC L5-S1 WITH
LEFT DOWNWARD MIGRATION AND BULGING L4-5 DISC.
Anamnesis
The patient came 28-January-2003 with agonizing
left sciatica for 20 days and LBP for two years.
MRI performed 19-January-2003 showing extruded
disc L5-S1 with left downward migration and
bulge L4-5 more to left.
On examination: scoliotic stance with SLRS 35
degrees both sides with pain more the left. He
had almost drop left foot and weak
planterflexion left foot 4/5. He had hypalgesia
left L5 and S1 territories. He had flat both
feet.
Laminectomy of L5 and partial of
L4 was performed. Foraminotomy of left S1 root was
achieved and the extruded disc was removed lateral
to the axilla. Left side cleaning of L4-5 and L5-S1
was performed.
Routine closure of the wound and smooth
postoperative recovery.
He was sent to the ward.
Follow Up
patient came to the clinic 15-February-2003 with
clean wound and no scoliosis with no motor, nor
sensory deficit. SLRS was 45 degrees in the left
with less pain.
Comments
The patient has extruded disc L4-5 and
L5-S1. The extrusion was more pronounced in the L5-S1, but
the extrusions were of the left side, for what cleaning was
performed in the two levels.
This solution could increase the estimated
recurrence rate up to 14% and the prolong the postoperative
recovery period.
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