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The patient was seen by me
08-October-2006 for LBP and right sciatica down
to L5 territory with MRI of
the lumbar spine done 17-September-2006 demonstrating slight extruded
disc L5-S1, which was treated conservatively. |
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The patient came to the
emergency of Al-Shmaisani hospital 30-May-2008 complaining of LBP with
agonizing right
sciatica for 3 days. Exacerbation of sciatica
the last 3 days with limping and difficult
walking and positive cough sign. |
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MRI lumbar spine performed
30-May-2008 showed extruded disc L5-S1 with
right downward migration. |
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On examination: the patient
in agonizing pain with exaggerated scoliotic
stance and inability to walk. SLRS was 25 degrees in the left with
pain and 5 degrees in the right. There was weak dorsi and planterflexion
right foot 3/5, hypalgesia right L5 and S1 roots
territory with absent AJ right side. |
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Right L5-S1 hemiflavotomy with
foraminotomy of right S1 root was performed. The
extruded disc was removed from under the axilla.
Meticulous cleaning of the disc space from the
right side. Inspection under the axilla and the
foramen for remnants. |
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The epidural fat was kept
untouched through the operation. |
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Routine closure of the wound
with prompt recovery of the power of left foot. |
