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The patient came to the clinic
23-July-2006 complaining of LBP with left sciatica for 6 months with
mild scoliotic stance with positive cough sign and exacerbation of
his sciatica the last month. MRI done 18-July-2006 showing huge
extrusion of L5-S1 disc in the left side. On examination: SLRS
right side 60 degrees, 30 degrees with pain in the left side
with absent AJ left side. Hypalgesia left S1 territory with weak
dorsi and planterflexion all toes left foot.
Left L5-S1 hemiflavotomy done with foraminotomy left S1 root.
The extruded material was removed in one piece lateral to the
axilla. Considering that, most of the intradiscal material came out
and the narrow space of L5-S1, it was decided not to violate the
disc space.
Comments: 1. Since most of
the disc material came out and the narrow disc space and minimal
defect in the annulus fibrosis, leaving the disc space without
violation logically minimize the recurrence rate. |