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30-APRIL-2007 AMAL MUHAMED AL-ATAWY 24 YEARS WIDE-BASED
EXTRUSION L5-S1 WITH LEFT SCIATICA AND WEAK BOTH FEET.
Anamnesis
The patient came to the clinic 20-November-2006
complaining of left sciatica down to the S1 root
territory.
MRI performed 11-November-2006 showed wide-based
huge extrusion of L5-S1 disc, more to the left.
On examination, SLRS was 90 degrees both sides
with only weak dorsiflexion left foot - 4/5.
MRI repeated the same day and the disc extrusion
is the same. The patient was advised to undergo
surgery.
The patient then came 02-April-2007 with new MRI
done the same day, showing the same extrusion.
SLRS was 75 degrees in the left with pain and
weak dorsi and planterflexion left foot.
Bilateral L5-S1 flavotomy was done and the hard
extrusion was removed from both sides and
meticulous cleaning of the disc space was
performed from both sides. All the rubbery
extrusion with the calcified annulus were
removed. Fat was harvested from near by soft
tissues and transferred to the roots.
Smooth postoperative recovery.
Comments
Removal only the extrusion over the last
three years increased the recurrence rate up to 30% with 7-10%
requiring surgery.
Meticulous cleaning also has its
disadvantages. In this case it was necessary to remove all the
extruded elements including the calcified annulus fibrosis to
achieve adequate decompression.
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Leica HM500
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Freedom combined with Outstanding Vision, but very bad video recording and
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After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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