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The patient came to the
clinic 25-December-2008 complaining of LBP and
bilateral sciatica
which took place 18 months after performing discectomy L4-5
2003 elsewhere. |
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On examination: the patient
has exaggerated scoliotic stance. SLRS
was 20 degrees both sides with agonizing pain
and she cannot sleep supine. She had weak dorsi
and planterflexion both feet 4/5 with numbness
all toes both feet. |
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MRI of the lumbar spine with
MRMyelography was performed 06-September-2008
showing huge recurrent disc L4-5 left side. |
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Considering that the patient
pain increased in the right side after the
performed MRI another MRI was requested and done
25-December-2008. |
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The patient is a known
diabetic and hypertensive and under treatment
with imuran for hypertrophic glomerulonephritis
for 6 months. Stenting of the coronary artery
was performed 1 month ago. |
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The patient was admitted one
day before surgery and mega doses of Vit C and
multivitamins were given to avoid possible wound
dehiscence after surgery. |
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Using image-intensifier, the
L4-5 level was identified and drilling of the
upper left corner of the bony defect was
performed. There was a lot of adhesion and the
disc space was reached lateral to the left L5
root axilla. Cleaning of L4-5 was performed.
after what the calcified extruded disc was
removed in several pieces. There was a lot of adhesion around the
root and trying to minimize the scar was
achieved. Routine closure of the wound with
water-tight multilayer stitching. |
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Smooth postoperative recovery
and the power of both feet normalized. |
