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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
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Multigen RF lesion generator .

 

01-MAY-2008  ISMAEEL ODEH ISSA 40 YEARS  EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION. 

Anamnesis:

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The patient came to the clinic 28-April-2008 complaining of LBP for 3 months with left sciatica.

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MRI performed 21-February-2008 showed extruded disc l4-5 with left downward migration.

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On examination: the patient is limping and using crutches for ambulation with scoliotic stance. SLRS was 80 degrees in the right and 20 degrees in the left with pain. He had weak dorsi and planterflexion left foot  3/5 with hypalgesia left L5 and S1 territories.

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Left L4-5 hemiflavotomy with left L5 root foraminotomy with removal of the extrusion lateral to the axilla was performed. Left sided intradiscal meticulous cleaning of L4-5 was done. It was necessary to remove the hard part of the annulus fibrosis, which was compressing the running root to eliminate the compressive elements. By doing this the defect of the annulus fibrosis became wider.

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Routine closure of the wound with smooth postoperative recovery.

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Considerable improvement of the power of the right foot.

Comments

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The expected recurrence is higher because the disc space is still having considerable height and the defect in the annulus fibrosis left wide.

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In case of recurrence the lateral mass was drilled more far-lateral, to give an ambience in case of recurrence to avoid severe pain in such possible future event.

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