The patient came
to
the clinic 15-November-2006 complaining of right sciatica for
15 days, down to S1 territory with positive cough sign. He came with
crutches, limping with scoliotic stance. On examination: SLRS
right side was 5 degrees and 75 in the left. Absent AJ right side.
Hypalgesia of right S1 and weak dorsi and planterflexion all toes
right foot were noted. MRI performed 16-November-2006 showing huge
extrusion L5-S1 right side.
Right L5-S1 hemiflavotomy with foraminotomy of the right S1 root
were performed and the extruded disc was removed. The extrusion was
actually the destroyed annulus fibrosis, which was hard and severely
compressing the root . Minimal cleaning of the disc space was
intentionally performed. Fat transfer to cover the root and
routine closure of the wound. Smooth postoperative neurologic
recovery.
Comments:
1. The defect in the annulus fibrosis was relatively not small,
making the possibility for recurrence higher than others. Time will
till. |