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15-OCTOBER-2009  HAYAT EED FARHAN  52 YEARS  HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Anamnesis:

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The relatives of the patient came to the clinic 07-October-2009 claiming that she is a known diabetic, complaining of LBP with left sciatica for 3 weeks. MRI lumbar spine performed 03-)ctober-2009 showing huge extruded disc  L5-S1 with left downward migration.

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The patient was admitted to Shmaisani hospital 14-October-2009 with with agonizing pain and weak dorsi and planterflexion left foot 3/5 with hypalgesia left L5 and S1 roots territories. SLRS was 5 degrees in the left with shooting pain. The patient was unable to stand for evaluating the scoliotic stance.

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Skeletonization of L5 lamina was performed. It was flail without isthmolysis. The ligamentum flavum was preserved and reflected to the right. Foraminotomy of left S1 root was achieved. The upward and far-lateral extrusion was removed and meticulous cleaning of L5-S1 disc space was achieved from the left. Further inspection of the flail lamina showed that it is movable in the facet joint, for what it was decided to leave it as it is.

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Routine closure of the wound and smooth postoperative recovery and the power of the feet normalized and the patient sent to the ward.


Comments

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From the MRI data it is hard to predict the flail lamina, and it was found during surgery.

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The importance of such finding will be clear several months after the performed surgery.


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