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The patient came to the
clinic with sudden onset LBP with drop feet for 3 weeks after
hospitalization in one hospital without performing MRI. The patient
had SLRS 10 degrees both sides with agonizing pain and bilateral
drop feet and weak planterflexion both feet. Hypalgesia both L5 and
S1 roots without cauda equina syndrome. The patient urged for
surgery and MRI performed showing huge central extrusion L4-5 with
big mass occupying both sides.
Bilateral L4-5 flavotomy with bilateral
foraminotomy of both L5 roots was performed and the extrusion was
removed from both sides and cleaning of the disc space was done from
both sides.
Comment:
Here is a case, that minimal cleaning of the disc
space is impossible, because all the time the disc material was
coming from the disc space and it was impossible to leave fragments
in the space. In the other side, attempt was made to preserve the
integrity of the lateral wall of the annulus fibrosis, to prevent
possible collapse of the disc space. | 
