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01-MARCH-2003 HURIYEH IBRAHEEM AL-SHALLAKH 61
YEARS EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
Comments
The recurrence rate in this case still
ranking around 7% because the disc space is not completely
collapsed.
Anamnesis
The patient came to the clinic 23-February-2003
complaining of LBP for 5 months with right sciatica
down to the big toe. MRI done 16-February-2003 showing
huge extruded disc L4-5 with right downward
migration.
On examination: the patient in pain,
limping with exaggerated scoliotic stance. SLRS
was 110 degrees with pain right side. There is
almost drop right foot.
Right sided hemiflavotomy L4-5
with foraminotomy right L5 root. The extruded disc was
attacked from the right and right sided cleaning of
L4-5 was done. Some fragments came subaxillary
and inspection of the subaxillary area revealed
fragments, which were pushed upward and removed. 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 radicular pain decreased and the power of right
foot normalized. She was sent to the ward.
Follow Up
The patient came to the clinic 12-March-2003
with clean wound normal motor and sensory
functions.
The patient then came several times and the last
visit was 26-June-2009 complaining of left
sciatica for 2 weeks with weak dorsiflexion left
foot 4/5. She was given medications and sent for
MRI of the lumbar spine and pelvis, but she did
not show up.
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Leica HM500
The World's first and the only Head mounted Microscope.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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