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08-APRIL-2003 ZUHAER JACOB ABU-ZUHAER 48
YEARS HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
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 05-April-2003
complaining of LBP with bilateral sciatica more
to the left with exacerbation of pain the last 3
days.
On examination: the patient in agonizing pain,
limping with exaggerated scoliotic stance. SLRS
was 40 degrees with pain right side and 10
degrees with more pain left side. There is
weak dorsi and planterflexion left foot.
The patient was sent for investigation and MRI
lumbar spine showing huge extruded disc L5-S1
with left far downward migration.
Left L5-S1 flavotomy with
extended foraminotomy left S1 root. The extruded disc
of L5-S1 was
removed subaxillary in three big pieces and then attacked from the left and left sided intradiscal
cleaning done. 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 decreased and the power of the
left foot improved. He was sent to the ward.
Follow Up
The patient came to the clinic 17-April-2003
with clean wound, slight improvement of power and sensation
left foot. SLRS was 35 degrees with less pain
left side. There is numbness left S1 territory.
The patient then came 14-November-2005
complaining of dysphasia with pti mal attacks.
He was sent for investigations, but disappeared.
The patient then came 07-July-2007 complaining
of LBP and left
sciatica. SLRS was 60 degrees left side and no
motor nor sensory deficit. The patient performed
MRI lumbar spine 15-April-2007 showing no
recurrence of the L5-S1 disc.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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Leica HM500
The World's first and the only Head mounted Microscope.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
