 |
The patient came to the
clinic 31-March-2004 complaining of neck pain
for 8 months with radicular pain left upper
limb. |
|
|
The patient was operated by
me 1986 for PLD L4-5. |
|
|
On examination at hat time:
the patient had hypalgesia both C5 roots
territories and left median nerve distribution
and left lower limb below the knee with weak
right upper limb and left quadriceps muscle. MRI
cervical spine done 31-March-2004 showed
PCD C3-4, and he was advised to undergo surgery
and he performed it elsewhere. |
|
|
The patient then came
25-February-2008 complaining of LBP with
intermittent claudication with numbness both
lower limbs for 45 days. He could not walk more
than 200 meters. |
|
|
On examination: Hoffmann sign
was positive in the left upper limb, with
scoliotic stance. The patient had hypalgesia
left S1 root territory and weak dorsiflexion
left foot. |
|
|
MRI lumbar spine performed
10-March-2008 showed showed severe stenosis L3-4
with calcified ganglion arising from the right
facet joint of L3-4. |
|
|
Decompressive laminectomy of
L3 was performed and the calcified ganglion was
drilled off and foraminotomy of right L4 root
was performed. The flail upper edge of the L4
lamina was removed also. The ligamentum flavum
between the calcified ganglion and the dura was
severely adherent to the dural and to the root. |
|
|
Routine closure of the wound
with smooth postoperative recovery. |
|
|
Immediate improvement of the
power of the left foot. |
