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Multigen RF lesion generator .

 

07-AUGUST-2008  FARIS ISMAT RASHEED HAUBSH  36 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 05-August-2008 complaining of LBP and right sciatica for one month. The patient suffered RTA in Naltshick 15 years ago with fracture of the pelvis.

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MRI done 07-June-2008 showed huge extrusion of L5-S1 with right sided extrusion with downward migration.

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On examination: the patient has exaggerated scoliotic stance, limping with SLRS 80 degrees with pain in the right. There is weak dorsiflexion right foot 4/5 and mild weak planterflexion.

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Right L5-S1 hemiflavotomy and right S1 root foraminotomy was performed. The extruded disc was removed lateral to the axilla in several pieces. The disc space was shallow and small amount came out despite meticulous cleaning, trying during that not to enlarge the defect in the annulus fibrosis.

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

Comments

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The estimated recurrence rate in this case is minimal, because the disc space is very shallow and the intradiscal material is small in amount.

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The epidural fat was missing at the root and compressed parts of the dural sleeve. Some attempt was paid to transfer the epidural fat without causing further damage to this tiny delicate tissue, to lower the incidence of postoperative scar formation.

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