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05-APRIL-2008 KAMAL MUHAMED ABDALLAH
50 YEARS HUGE RIGHT FAR-LATERAL EXTRUSION L5-S1 WITH UPWARD
MIGRATION.
Anamnesis:
The patient came to the
clinic 31-March-2008 complaining of LBP for 1
month with right sciatica for 16 days with
numbness and pain right L5 territory.
MRI of the lumbar spine
performed 26-March-2008 showed extruded disc
L5-S1 with right far-lateral and upward
migration with foraminal occlusion.
On examination: the patient
was limping with scoliotic stance. SLRS was 65
degrees with pain in the right with absent AJ
right side. There was hypalgesia right L5 and S1
root territories. He had almost drop right foot
and weak planterflexion right foot 3/5.
Right L5-S1 hemiflavotomy
with right S1 foraminotomy with removal of the
upward and far-lateral extrusion lateral to the
axilla, which was shifted medially. Meticulous
cleaning of L5-S1 disc space from the right
side.
Routine closure of the wound
with smooth postoperative recovery.
Moderate improvement of the
power of the right foot.
Comments
The extrusion had a
surrounding reactionary changes, which could be
explained by the presence of some hidden
inflammatory process.
The disc space height is
slightly shallow, which could decrease the
expected recurrence rate.
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