 |
The patient came to the
clinic 15-January-2008 complaining of right hip
pain for 25 days with right sciatica down to
right L5 territory. |
|
|
MRI lumbar spine performed
09-January-2008 demonstrating extruded disc
L5-S1 with right huge far-lateral disc
protrusion and left upward migration. The
patient cannot walk more than 20 meters. |
|
|
On examination: SLRS
was 80 degrees in the right and 90 degrees in
the left. with weak dorsiflexion both feet 4/5,
and hypalgesia right L5 territory. |
|
|
The patient was advised to
keep in conservative treatment in the hope, that
the far-lateral extrusion can get a shift or
resorption. |
|
|
The patient could not wait
and the pain became agonizing, that another MRI
was performed 19-January-2008 confirming, that
the lesion still the same. |
|
|
Bilateral flavotomy of L5-S1
was done. It was so wide, that, it was necessary
to use the image-intensifier, the level was
identified and the right far-lateral extrusion
was seen and a huge amount of extrusion was
removed. The left upward migrating material was
attacked from the left side and removed. |
|
|
Bilateral meticulous cleaning
of the disc space was achieved. |
|
|
Routine closure of the wound. |
|
|
Smooth postoperative recovery
and the power of both feet dorsiflexion
improved. |
