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10-APRIL-2003 NABEEL ADNAN MDANAT 41
YEARS HUGE EXTRUDED DISC L4-5 LEFT FORAMINAL OCCLUSION.
Comments
The recurrence rate in this case still
ranking around 7% because the disc space is not completely
collapsed.
Anamnesis
The patient came to the clinic
07-April-2003
complaining of LBP for 5 years with left sciatica for
3 months with positive cough sign. MRI cervical
spine performed 24-March-2003 showing bulge C3-4
right side and lumbar spine showing huge
extruded disc L4-5 more to the left.
On examination: the patient in pain,
limping with exaggerated scoliotic stance. SLRS
was 45
degrees with pain left side. There is weak
dorsiflexion left foot -4/5.
Left hemiflavotomy L4-5 with
extended foraminotomy left L5 root. The extruded disc
of L4-5 was
attacked from the left axilla and left sided cleaning
of L4-5 was achieved until the root became
lax. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain disappeared and the power of the
left
foot normalized. He was sent to the ward.
Follow Up
The patient came to the clinic 30-April-2003
with clean wound with no sensory or motor
deficit. SLRS was 70 degrees with minimal pain.
The patient then came 01-April-2006 complaining
of right sciatica with SLRS right 30 degrees
with pain and weak dorsiflexion right foot and
given medications and sent for investigations,
but he disappeared.
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Notice: Head injuries and very urgent surgeries are also
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