The patient was admitted to Shmaisani hospital with sudden onset LBP for 1 week and agonizing left sciatica with disappearance of the sciatica replaced by flail left foot.

MRI Lumbar spine performed 02-April-2010 showing huge extruded disc L3-4 central more to the left obstructing the spinal canal completely.

On examination: the patient is in bed with flail left foot and severe weak right foot and analgesia of the left leg below the knee level.

MRI of the dorsal spine performed 03-April-2010  showing tiny disc at D8-9.

Before the surgery in reexamination: the patient showing bilateral flail feet.

Using image-intensifier the L3-4 level was identified and bilateral flavotomy of L3-4 was achieved. The extruded huge disc was removed from the left side in one big piece. Left sided cleaning of the disc space was performed meticulously.

Routine closure of the wound.

Smooth postoperative recovery, with very slight improvement of the movement of the right foot.

The roots were severely damaged by the big extrusion. Recovery will take time to have full recovery. The right foot mostly will recover earlier than the left.

PLD usually take place at L4-5 and L5-S1 level. It is more rare to have PLD L2-3 of L3-4. The surprising situation, that during one moth 3 cases were operated with similar data. To see the other cases click here and here!