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05-APRIL-2008  KAMAL MUHAMED ABDALLAH  50 YEARS  HUGE RIGHT FAR-LATERAL EXTRUSION L5-S1 WITH UPWARD MIGRATION.

Anamnesis:

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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.

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MRI of the lumbar spine performed 26-March-2008 showed extruded disc L5-S1 with right far-lateral and upward migration with foraminal occlusion.

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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.

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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.

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Routine closure of the wound with smooth postoperative recovery.

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Moderate improvement of the power of the right foot.

Comments

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The extrusion had a surrounding reactionary changes, which could be explained by the presence of some hidden inflammatory process.

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The disc space height is slightly shallow, which could decrease the expected recurrence rate.

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