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24-MAY-2007 FATIMA MUHAMED ABDALLAH 62 YEARS PLD L2-3 WITH
LEFT FORAMINAL COMPRESSION. RESIDUAL AFTER DISCECTOMY OF L3-4 RECURRENCE
PERFORMED 1993.
Anamnesis
The patient came to the clinic 19-May-2007
complaining of LBP with left sciatica the last 2
months. The patient was operated by me 1993 for
recurrence at L3-4 disc. The patient is a known
diabetic -insulin dependant and hypertensive for
three years.
MRI performed 16-May-2007 showing PLD L2-3 with
left foraminal compression and downward
migration.
On examination: the patient in agonizing pain
with SLRS 30 degrees in the left with weak
dorsiflexion both feet more the left with weak
left quadriceps muscle 4/5, adduction of the
knees 3/5.
The uppermost left corner of the previous
surgery was refreshed and the facet was drilled
in the medial side and the left L2 root was
identified and the extruded bony and fragmented
disc was removed lateral to the axilla. The
extrusion was adherent to the root, for what
microscopic sharp dissection was performed to
avoid tearing of the root. Foraminotomy of the
left L3 root was performed and the root is
hanging free.
Smooth postoperative recovery. The patient sent
to the ward.
Comments
The patient underwent previous surgeries for
the spine at L3-4. The stress points at the neighboring disci
increase, which make them more susceptible for disc formation.
The clinical course of the patient is more
protracted than, the patient claim. The presence of adhesions
with the root cannot be formed within 2 months. It must have at
least 1-2 years to have such process.
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