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26-OCTOBER-2010 FAKHRY FUAD AL-DAJANI 30 YEARS EXTRUDED DISC
L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The
patient came
to the clinic 21-October-2010 with history of
LBP and right sciatica for 8 months.
MRI performed
21-October-2010 showing bulge L3=4, L4-5 and
extruded disc L5-S1 with right downward
migration, compressing the right S1 root.
On examination: The
patient is limping with exaggerated scoliotic
stance. SLRS was 15 degrees with pain in the
right. There is weak dorsiflexion -4/5 of the
right foot. The
patient had stiff back and unable to bend the
spine.
Right partial flavotomy L5-S1 was performed.
Right S1 root foraminotomy. The
extruded downward migrating disc was removed
lateral to the axilla. Right sided cleaning L5-S1
disc space. The compressed tissues were lacking
the epidural fat. After decompression the root
became lax.
Routine closure of
the wound and smooth postoperative recovery
disappearance of right sciatica and normalization
of the power of the right foot.
Comments
The patient has disc extrusion compressing
severely the right S1 root, for what an agonizing
pain having place.
The disc extrusion was
dark-gray, for what the chance
for shrinkage over the time is ranking less than
10%. ( The white-gray disc extrusion have to
shrink over the time more than 80% chance during
6-10 weeks).
The estimated postoperative
recurrence rate in this case is around 7%,
because the disc space is still not shallow.
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