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08-AUGUST-2004 HUDA ABDEL-RAHMAN JALAFNEH 40
YEARS HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the
clinic 04-August-2004 with agonizing LBP with
left sciatica
for 3 weeks, down to S1 root
territory. MRI lumbar spine
done 02-August-2004 showing huge extruded disc
L5-S1 with left downward migration. She had LBP
for 5 years with intermittent course.
On examination, the patient in agonizing pain,
limping with exaggerated scoliotic stance with
drop left foot and weak dorsiflexion right foot 3/5
and planterflexion both feet with hypalgesia
left L5 and S1 territories. SLRS was 20
degrees with pain left side and 45 degrees
right side with
pain.
Foraminotomy right S1
root was achieved.
Right sided intradiscal cleaning L5-S1 was
performed. The patient was put in Reverse
Trendelenburg position with Valsalva maneuver
and hyperventilation. No CSF leak. The epidural
fat was transferred to the left axilla area. A fat was
harvested from the
subcutaneous layer with pedicle and transferred and covered the exposed parts
of the root to minimize postoperative
scarring. The ligamentum flavum returned back in
place. Routine closure
of the wound.
Smooth postoperative recovery. The power of
the right foot normalized.
FOLLOW UP
The patient
came to the clinic 18-August-2004 with clean wound and no motor,
nor sensory deficit.
Comments
There is still an
estimated postoperative recurrence around 7%,
because the disc space is still not completely
collapsed.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
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
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
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Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
