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03-MARCH-2004 NASEEM MUHAMED BASTUNEH 34 YEARS
POST-TRAUMATIC EXTRUSION L5-S1 AND CHEMONUCLEOLYSIS WITH RIGHT AGONIZING SCIATICA.
Anamnesis
The patient came to the clinic 28-February-2003
complaining of LBP with right sciatica after
falling down 07-July-2003 and got contusion
right kidney. MRI lumbar spine performed
07-January-2004 showing extruded disc L5-S1 with
right downward migration. Epidural injection and
chemonucleolysis underwent three times elsewhere
without effect. Positive cough sign.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS was 5
degrees right side with pain and 30 degrees left
side with pain. There is weak dorsi and planterflexion
right foot -4/5 with hypalgesia right L5
territory.
The patient was sent for investigations and MRI
lumbar spine performed 01-March-2004 showed
the same extrusion.
Right S1 foraminotomy with
removal of the extrusion lateral to the axilla. After
that, the root became lax and right sided
intradiscal cleaning L5-S1 disc space was done.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. A free fat was
harvested from the subcutaneous layer and
covered the exposed parts of the root, to
minimize postoperative scarring. Routine closure
of the wound. Smooth postoperative recovery. The
power of the right foot normalized.
FOLLOW UP
The patient came to the clinic 22-March-2004
with clean wound and SLRS 70 degrees right side
with pain and normal power and hypalgesia right
S1 root territory.
The patient then came 10-April-2004 with MRI
lumbar spine performed the same day ruling out
recurrence, complaining
of hypalgesia right S1 root territory.
The patient then came 14-June-2004 complaining
of LBP with right sciatica 2 weeks after
returning to work. He was treated
conservatively.
Comments
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still relatively shallow.
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