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The
patient came to the clinic
07-May-2011
complaining of LBP and right sciatica for 12
years with exacerbation for 45 days with agonizing
right sciatica. |
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On
examination: the patient is limping with
exaggerated scoliotic stance with SLRS was 60
degrees in right side . The Achilles' Jerk is absent
in the left side. There is weak
dorsiflexion both feet 3/5 and planterflexion
right foot 3/5. |
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MRI of the lumbar
spine performed 21-April-2011 showing huge
extruded disc L4-5 with right foraminal
occlusion and upward migration. |
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The
patient is a known case with cardiomegaly
and arrhythmia and he was sent for
cardiologic evaluation. MRI of the brain
performed 08-May-2011 showing scattered
periventricular infarctions both cerebral
hemispheres. MRI dorsal spine was normal. |
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Right L5 foraminotomy with partial
L4-5 flavotomy was performed from the right
using image intensifier. The
extruded upward migrating disc was removed lateral to the root.
Right sided
cleaning L4-5 disc space was achieved. The area
was lacking the epidural fat due to severe
compression. The root and dural structures
regained relaxed position at the end of surgery. |
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Routine
closure of the wound. The sciatica
disappeared and the power of the left leg
improved. |
