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11-AUGUST-2007 AMNEH ABDEL-FATTAH AL-QANNAS 70 YEARS RIGHT FAR-LATERAL DISC
L4-5 WITH FORAMINAL STENOSIS AND SMALL EXTRUDED DISC L5-S1 COMPRESSING THE RIGHT
S1 ROOT.
Anamnesis
The patient came to the clinic 06-June-2007
complaining of right sciatica for 2 weeks with
LBP for 5 years. Using crutches for 1 week and
positive cough sign.
MRI lumbar spine performed 31-May-2007 showed
PLD L4-5 right far lateral with foraminal
occlusion and small extrusion L5-S1 right side
touching the right S1 root.
On examination: SLRS 30 degrees in the right and
70 degrees in the left with hypalgesia right L5
territory and weak dorsiflexion right foot 3/5.
The patient was advised to continue in
conservative treatment, but she came
05-August-2007 confirming no improvement at all.
On examination the hypalgesia is wide spread to
involve the right L4-5 and S1 roots with weak
dorsi 3/5 and planterflexion 4/5 of the right
foot.
Right hemilaminectomy of L5 with foraminotomy of
both L5 and S1 right side was performed.
Meticulous cleaning of L4-5 was performed from
the right and the foramen was checked for
patency and redundancy for the running root.
Inspection of the right S1 root revealed a
mobile small extrusion compressing the root.
This extruded piece was removed without
violating the L5-S1 disc space.
Smooth postoperative recovery.
Comments
The patient before surgery had major problem
at L4-5 level, which brought her to surgery. During surgery, the
extruded small disc at L5-S1 was more convincing for her
agonizing pain.
The L5-S1 disc space was not violated, so as to make the
postoperative course more easier and to limit the inflammatory
process in case of possible involvement in the future,
considering that the patient is a known diabetic.
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