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02-MARCH-2008  ISSA MINWER AL-SALAYTAH  36 YEARS  VERY HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 12-February-2008 complaining of LBP for 20 days with left sciatica and numb left foot with positive cough sign.

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MRI lumbar spine done 04-February-2008 showing huge PLD L5-S1 with left downward migration.

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On examination: the patient is limping and dragging his left leg and has scoliotic stance. SLRS was 50 degrees in the right and 25 degrees in the left with radiating pain to the left leg. The patient had weak dorsiflexion left foot 4/5 and hypalgesia left S1 territory.

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Foraminotomy of left S1 root was performed and partial flavotomy of L5-S1 was done. The extruded disc was removed from under the axilla in three successive big pieces. Inspection of the disc space, confirmed that the disc space was practically obliterated, for what it was decided not to violate it.

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Routine closure of the wound and smooth postoperative recovery with normalization of the power of the left foot.

Comments

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Foraminotomy of the involved root must be done in all disc surgeries to be sure that there is no remnant left under the axilla.

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The disc space was very shallow, for what the expected recurrence rate in this case is almost zero.

 

 


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