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The patient came to the
clinic 12-January-1999 complaining of
LBP with without sciatica for 5 years. MRI of
the lumbar spine done 20-November-1998 showed
extruded disc L3-4. He had prostate hypertrophy
in cardura for 2 years. |
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On examination at that time:
he had exaggerated scoliotic stance with weak
dorsiflexion left foot 4/5. The patient was
treated conservatively. |
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The patient then came
02-December-2003 with exacerbation of LBP
without sciatica. His clinical status was the
same as before and the MRI performed
13-November-2003 was the same as before. The
patient was treated conservatively.
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The patient then came
16-July-2008 complaining of severe left sciatica
for the last three days. |
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On examination: the patient
in agonizing pain with exaggerated scoliotic
stance with SLRS 75
degrees in the left with pain with weak dorsiflexion right foot
-4/5. |
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MRI of the lumbar spine was
performed 15-July-2008 showing huge PLD L3-4
with left downward migration. |
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Using image-intensifier, the
L3-4 level was identified and left L3-4
hemiflavotomy and left L4 foraminotomy was done.
The epidural fat was missing at the compressed
parts and the root was severely compressed. The
downward migrating piece was removed lateral to
the axilla in two separate pieces, after what
the root became lax. Meticulous cleaning of the
disc apace was performed from the left side. |
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Routine closure of the wound
with normalization of the power of the left
foot. |
