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15-MAY-2003 FAWZIYEH TAHER AL-ZAKARNEH 61
YEARS EXTRUDED DISC L4-5 WITH RIGHT UPWARD MIGRATION.
Comments
The estimated postoperative recurrence is
around 7%, because the disc space is still not completely
shallow.
With time the patient will suffer from
various diseases.
Anamnesis
The patient admitted to the hospital 14-May-2003 complaining of LBP for
3 days with agonizing right sciatica. She is
diabetic and MRI done recently showing extruded
disc L4-5 with right upward migration.
On examination: the patient is in agonizing
pain, limping with exaggerated scoliotic stance
with SLRS 70 degrees right side with pain and 80
degrees left side with pain. She has weak dorsi
and planterflexion right foot 4/5. There is
hypalgesia right L5.S1 roots.
Right side hemiflavotomy L4-5
with foraminotomy right L5 root with removal of the
extrusion from the right side lateral to the axilla.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. Routine closure of
the wound. Smooth postoperative recovery.
She was sent to the ward.
Follow Up
The patient came to the clinic 27-May-2003 with
clean wound with full power right foot and
normal sensation. SLRS was 90 degrees both sides
without pain.
The patient then came 16-Septemebr-2003
complaining of neck pain with new MRI lumbar
spine performed 12-August-2003 showing no
recurrence at L4-5. There was weakness grip and
extension left hand and left triceps muscle. The
patient was sent for investigations and MRI
cervical spine.
The patient then came 30-May-2004 with LBP for
45 days with right sciatica with hypalgesia
right L5 root and weak dorsiflexion right foot.
She was given admission for investigations, but
disappeared.
The patient then came 20-December-2015 with left
upper limb pain with inability to sleep. She was
operated 2010 at Hamzah hospital for LCS, after
what she is in wheelchair. There is weak flexion
and extension left foot 3/5 and left triceps
muscle -3/5 with analgesia left ulnar nerve
territory. MRI cervical spine done
20-December-2015 showing extruded disc C6-7
with left foraminal occlusion. She was advised
for surgery, but she escaped.
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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 .
