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01-JANUARY-2008 ABED AWWAD FALAH 47 YEARS PLD L5-S1
WITH HUGE RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the
clinic 27-December-2007 complaining of LBP with
right sciatica for for 15 days, with
exacerbation the last 4 days and numbness of the
right S1 territory.
On examination: the patient had weak
dorsi and planterflexion right foot 4/5
with scoliotic stance and SLRS 5 degrees right
side and absent AJ same side.
MRI lumbar spine performed
30-December-2007 showing huge extruded disc L5-S1 with right
downward migration.
Right L5-S1 hemiflavotomy with
right S1 foraminotomy was performed and the extruded disc
was removed lateral to the axilla. Meticulous cleaning of
the disc space from the right side with inspection of the
subaxillary area for remnants.
Routine closure after epidural
fat transfer with smooth postoperative recovery.
Comments
The disc space is shallow and
the extrusion was big and the removed disc
material was 7.2 mg. All these factors with the
small defect in the annulus fibrosis, making the
expected recurrence rate lower than average.
