The patient came to the clinic with agonizing pain with
sciatica and severe weak dorsi and planterflexion of the left foot
with SLRS right 10 degrees. She was sent for MRI lumbar spine, confirming the presence of
huge prolapsed disc L5-S1 left side. She had LBP for 3 years, but
the severe sciatica for 7 days.
The patient was operated: Left L5-S1
hemiflavotomy was done with foraminotomy of left S1 root. The huge
extrusion was removed in one piece from under the axilla, after what
the root became relaxed and free. The root shifted medially and the
disc wall was inspected and it was glistening and no compression was
seen. Considering the huge extrusion and the absence of compression
from the disc wall, the disc space was not violated.
The main attention for this policy is to monitor the rate of
recurrence. It is early to predict the long-run outcome of this
policy, but it merits outweighing its cons.