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17-SEPTEMBER-2007 MAYSOON MUHAMED AL-AWWA 36 YEARS EXTRUDED DISC L5-S1 RIGHT
SIDE.
Anamnesis
The patient came to the clinic 10-September-2007
complaining of LBP for 3 years with exacerbation
the last three months. The last 2 months got
right sciatica. MRI lumbar spine done
07-July-2007 showing extruded disc L5-S1 right
side.
On examination: SLRS was 45 degrees in the right
and 80 degrees shooting to the right leg. There
was weak dorsiflexion both feet and
planterflexion right foot. The patient was given
pain killers and new MRI was requested. The new
MRI performed 12-September-2007 showing
enlargement of the extrusion and she was advised
to undergo surgery.
right L5-S1 1/3 flavotomy with partial
foraminotomy of right S1 root was performed. The
root was severely compressed by the extrusion
and there was no fat surrounding it. The
extrusion was removed lateral to the axilla and
meticulous cleaning of the disc space was
performed from the right. Routine closure of the
wound after fat transfer around the root.
Smooth postoperative recovery and normalization
of the power of both feet.
Comments
The disc space was narrow, which minimize
the expected recurrence rate.
The extrusion was not large, but it was
causing direct compression at the root, which caused the
agonizing pain.
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