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20-SEPTEMBER-2003 FATMEH HUSSEIN RAJEH 52
YEARS EXTRUDED DISC L4-5 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient a Yemeni citizen, came to the clinic
16-September-2003 complaining of LBP for 1 year
and right
sciatica for 4 months with radiation down to the
right L5 root territory. MRI lumbar spine done
11-September-2003 showing huge extruded disc L4-5
right side.
On examination: the patient is in agonizing
pain, limping with exaggerated scoliotic stance.
SLRS was 90 degrees both sides with pain. There
is weak dorsiflexion both feet with hypalgesia
right L5 root territory. There is also weak grip
and extension right hand with weak right triceps
muscle.
The patient was sent to perform MRI cervical
spine with no significant findings.
Decompressive laminectomy
L4-5 with foraminotomy both L5 roots.
The extruded disc was removed lateral to the
axilla and bilateral intradiscal cleaning of
L4-5 space was achieved. The epidural fat was
transferred around the roots to minimize
postoperative adhesions. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak.
Routine closure of the wound. Smooth
postoperative recovery. The power of both feet normalized.
FOLLOW UP
The patient
came to the clinic 01-October-2003 with clean wound
and the power and sensation of the feet
became normal. SLRS was 90 degrees with tightness
right side.
Comments
There is still an
estimated postoperative recurrence around 7%
because the disc space is not completely shallow.
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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
escaped from the plan .
