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03-OCTOBER-2008  AHMAD ODEH AL-LAWI 75 YEARS  DE NOVO POSTTRAUMATIC HUGE EXTRUDED DISC L2-3 MORE TO THE RIGHT . CONDITION AFTER DECOMPRESSIVE LAMINECTOMY  FOR LCS L3-4, L4-5 2 MONTHS AGO.

Anamnesis:

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The patient came to the emergency of Al-Shmaisani hospital 03-October-2008 complaining of bilateral sciatica with inability to walk for 8 days.

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The patient was operated by me 21-August-2008 for LCS L3-4 and L4-5.

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MRI performed today showing a huge de novo extruded disc L2-3 more to the right.

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On examination: the patient in agonizing pain and has weak both quadriceps muscles 4/5 and weak dorsiflexion both feet 3/4 and abduction of the knees 4/5. SLRS was 90 degrees both sides.

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During dissection of the spinous process, it came obvious, that there is fracture of the spinous process and the right medial part of the L2-3 facet, which were subsequently removed.

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The right L3 root was identified and the huge extruded disc L2-3 was removed intentionally in several pieces, so as to prevent dural damage.

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Meticulous cleaning of disc space of L2-3 was performed from the right.

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Routine closure of the wound. The power of both legs improved more in the right side.

Comments

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The patient underwent decompressive laminectomy of L3-4 and partially of L2 and L5 2 months ago.

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The patient and the family were interrogated after surgery and they told us that the patient felt twice, after what he got this complication.

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There is no connection between the two events, and by no means the second surgery has relation with first.

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The estimated recurrence in this case is below average, because the disc height is shallow.

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