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The patient came to the clinic complaining of severe right sciatica
with with almost right drop foot with exaggerated scoliotic
stance and pain in standing and walking. The condition took place
for 6 months with progressive course. On examination beside the
drop foot there was hypalgesia of the right L5 dermatome. The
patient was sent for MRI and a huge extrusion of L4-5 was confirmed.
Right L4-5 hemiflavotomy with foraminotomy of right L5 root was
done and the extrusion was removed lateral to the axilla.
Considering that the disc space was severely narrowed in the left
side, meticulous cleaning of the disc space was performed from the
right side, hoping to achieve symmetrical narrowing of the disc
height to accelerate the disappearance of the exaggerated scoliotic
appearance. Inspection for for slipped epiphysis was negative.
Comments:
1. In the paediatric group of patients undergoing discectomy
slipped epiphysis is the usual finding, but in this case, the age of
the patient is in the border-line and no presence for slipped
epiphysis was noted. He was demonstrating the usual picture seen in
adults. |
