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03-MAY-2007 MARYAM ABDALLAH AL-KHATEEB 75 YEARS EXTRUDED
DISC L1-2 WITH LEFT UP AND DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 28-April-2007
complaining of LBP with left sciatica for 1
month.
MRI lumbar spine performed 24-April-2007 showing
a mass behind the bodies of L1 and 2 mostly an
extruded disc L1-2 with up and downward
migration left side.
The patient had Parkinson disease. On
examination: SLRS was 90 degrees both sides with
weak dorsiflexion both feet and exaggerated
scoliotic stance. She was complaining of
dripping of urine.
Under image-intensifier the L1-2 was marked by
methyline-blue and left L1-2 hemiflavotomy was
performed and drilling of the left lateral mass
was done to prevent traction injury to the
spinal cord. Foraminotomy of the left L2 root
was done with preservation of the isthmus. The
root was severely compressed by underlying mass
which was removed in several pieces, which
proved to be an extruded disc material.
Inspection of the disc surface , confirmed the
proposal not to violate the intradiscal space.
The root became free and the exit was wide.
Routine closure.
Smooth postoperative recovery.
Comments
Extruded disc at L1-2 with such migration is
a rarity and the surgical maneuvers are directed to avoid any
traction to the dura, to avoid traction injury to the spinal
cord.
Drilling the medial part of the left lateral
mass gave an ample to expose the compressed nerve and subsequent
removal of the extrusion without causing any traction injury to
the spinal cord.
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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
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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 .
