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12-MARCH-2008 MUHAMED YASER MARRAR 21 YEARS
HUGE EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 11-March-2008 complaining of LBP for 10
days with right sciatica. He was walking with
difficulty.
On examination: he had
exaggerated scoliotic stance. limping during
walk with SLRS 60
degrees. Weak dorsiflexion and planterflexion
right foot. He had hypalgesia below right knee.
MRI lumbar spine performed
05-March-2008 showing bulge L4-5 with
huge extruded disc L5-S1 and downward migration to the
right.
Under image-intensifier,
because he had very wide L5-S1 intralaminar
space, the level was
identified, and right hemiflavotomy L5-S1 with
foraminotomy right S1 root was done. The
extruded disc was pushing the S1 root laterally,
for what it was attacked from under the axilla.
The extruded disc was stuck and it was necessary
to remove it in several pieces. After complete
removal of the extrusion, meticulous cleaning of
L5-S1 space was performed from the right.
Routine closure of the wound
with smooth postoperative recovery.
Immediate recovery of the
power of right foot.
Comments
The disc space is still high
and despite the fact, that meticulous cleaning
of the disc space was achieved, the recurrence
rate in this case will remain relatively high
around 7%.
