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The patient came to the
clinic 14-August-2007 complaining of LBP and
left sciatica for three months |
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On examination: the patient
has exaggerated scoliotic stance. SLRS
was 20 degrees right side and 5 degrees in the
left with agonizing pain and. He had weak dorsi
and planterflexion left foot 3/5 with hypalgesia
left L5 root territory. |
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MRI of the lumbar spine with
MRMyelography was performed the next day and
huge extrusion of L5-S1 with lumbarization of
the sacrum was noted. The patient was advised to
undergo surgery, but he disappeared. |
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The patient then came
13-December-2008 with agonizing bilateral
sciatica for the last 20 days. He had weak both
feet with dorsi and planterflexion 3/5. He could
not stand upright and walked bended with the
help of two persons. |
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Considering that the patient
pain increased in the right side after the
performed MRI another MRI was requested and done
13-December-2008 which confirmed the persistence
of the huge disc L5-S1. |
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Bilateral L5-S1 flavotomy and
bilateral S1 foraminotomy was performed. There
was no epidural fat in the area due to severe
compression. The huge extruded disc was attacked
from the left side lateral to the axilla. The
extruded disc was removed in several pieces and
meticulous cleaning of the disc space was
performed from the left side. Inspection of the
right side showed no extrusion and the annulus
fibrosis was lax. Routine closure of the wound
with water-tight multilayer stitching. |
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Smooth postoperative recovery
and the power of both feet normalized. |
