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30-AUGUST-2007 FARID AZZAM FARID 25 YEARS HUGE EXTRUDED DISC L5-S1 LEFT
SIDE.
Anamnesis
The patient came to the clinic 13-August-2007
complaining of LBP for 3 months with left
sciatica. MRI performed 20-May-2007, showing
huge extruded disc L5-S1 left side.
On examination at that time he had scoliotic
stance with left sciatica with SLRS was 45
degrees in the left with pain with weak
dorsiflexion all toes left foot. He was planning
for wedding tomorrow and he was given
medications to make him able to go through his
marriage in acceptable position and to perform
MRI after the wedding.
The patient came 27-August-2007 with new MRI
showing the same huge extrusion.
On examination: the patient had the same
scoliotic stance with left sciatica and weak
dorsiflexion all toes left foot.
Left 1/3 L4-5 flavotomy with foraminotomy of
left S1 root was performed. The extruded disc
was removed lateral to the axilla. Meticulous
cleaning of the disc space from the left side
was achieved.
Routine closure and smooth postoperative
recovery and normalization of the power of both
feet.
Comments
The patient is an obese with the fat
layer more than 15 cm. The incision was 5 cm long. Special
adapted instrumentation is required for such surgery.
The expected recurrence rate in this case
is in the usual average, because he is obese, and the disc
space height is not shallow. These factors increase the
expected recurrence rate.
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