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09-SEPTEMBER-2010 MUHAMED AWWAD MUSA DAWOOD 47
YEARS SECOND RECURRENCE OF PLD L4-5 WITH LEFT MASSIVE COMPRESSION.
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Anamnesis
The
patient was
operated be me for recurrent PLD L4-5 with left
downward migration
17-January-2009.
The patient then
came to the clinic 07-September-210 complaining
of LBP for three weeks and progression of left
sciatica the last 3 days.
On examination: SLRS
was 80 degrees both sides without neurological
deficit.
MRI lumbar spine
with contrast was performed 08-September-2010
showing huge recurrence of L4-5 with left up and
downward migration with collapse of the disc
height.
Left L4-5 scarolysis
with exposure of the dura and the left L5 root. The
extruded disc was removed in several pieces lateral
to the axilla. Left sided cleaning L4-5 disc
space, which was narrow.
Routine closure of
the wound and smooth postoperative recovery with
disappearance of left sciatica.
Comments
The estimated postoperative
recurrence rate in this case is below the
average - 7%, because the disc space is
shallow and practically no intradiscal material
left behind.
Using PEEK Satellite spheres
of Medtronic was abandoned by us and in the case
of recurrence, it is better to remove
recurrence, instead of performing procedures,
which has high profile of complications.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
