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13-APRIL-2010 SALEH ABDALLAH AL-SAADY
70 YEARS LUMBAR CANAL STENOSIS WITH OLD EXTRUDED DISC L4-5 WITH
RIGHT FORAMINAL OCCLUSION.
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Anamnesis
The
patient came
to the clinic 10-April-2010 complaining of
LBP with walking difficulty for 10 years
with exacerbation last year with bilateral
sciatica more the right.
MRI
lumbar spine
performed 21-November-2009 showed severe lumbar
canal stenosis L4-5 with with extruded disc L4-5.
On examination: the
patient is dragging the right lower limb
with weak dorsiflexion left foot
4/5 and right foot 3/5.
The patient was advised to
repeat MRI of the lumbar spine, which was done
11-April-2010 was a bad quality one and then
repeated 12-April-2010 which confirmed the
presence of the stenosis and the extrusion with
right foraminal occlusion.
Decompressive laminectomy L4 and
partial of L5 was performed and the annulus
fibrosis of L4-5 was checked for fresh extrusion. It
was negative both sides. Foraminotomy of the left
L5 root was performed easily, but it was necessary
to extend foraminotomy for 17 mm along the right L5
root to achieve acceptable release. Considering that
the extrusion at the right side was glistening and
not movable with calcified surface, it was decided
not to violate the disc space.
Routine closure of the wound.
Smooth postoperative
recovery, with
full recovery of the
power of both feet.
Comments
Lumbar canal stenosis is a
progressive disease and the sooner the better
the outcome.
Considering that the right L5
root was badly compressed, postoperative recovery was anticipated
after release.
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 .
