|
The patient an Iraqi citizen came to the hospital 1 month ago
with a history of discectomy L4-5 2 months ago in Syria. MRI
performed before surgery showed only elements of segmental stenosis
at L4-5. MRI performed upon admission were that of osteomyelitis of
L4 and 5 bodies. The patient was investigated for septic work and
she was discharged under long-term therapy with dalacine 300 mg
twice a day. Dalacine caused diarrhea, for what it was stopped 2
days ago.
The patient then came 24-December-2006 for follow up and she got
mild improvement of her clinical signs with SLRS 30 degrees in the
right and 40 degrees in the left with weak dorsi and planterflexion
of the toes right foot with hypalgesia of the right L5 territory.
MRI performed 20-December-2006 showing worsening of the morphologic
picture, for what it was decided to admit her for thorough
investigations.
Under G.A. percutaneous discectomy of L4-5 from the left
side was performed and attempts were created to obtain the disc and
bony material for histological and all possible causes including
tbc.
27-December-2006: The investigations ruled out the presence of
tumor or tuberculosis and the patient was put in ciproflacine
instead of dalacine.
Comments:
1. To my knowledge, I was the first in Jordan who introduced
percutaneous discectomy 15 years ago. During 4 years period, I
performed 8 operation in the first year, then 6 operations the
second and 4 operations the third and 2 operations the fourth year.
It became clear that, percutaneous discectomy have no place in disc
treatment and it was abandoned by me, because bulging disc
needs only rest for a couple of weeks to subside. I use this
technique only for special circumstances, such as in this case |
