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Multigen RF lesion generator .

 

11-JUNE-2008  MANAL ABDALLAH SUWWAN  37 YEARS  DE NOVO PLD L3-4  WITH LEFT FAR-LATERAL EXTRUSION, OBLITERATING THE FORAMEN. RESIDUAL AFTER TWO SURGERIES FOR PLD L4-5.

Anamnesis:

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The patient came to the clinic 07-June-2008 with sciatica for three weeks more the left. She was operated 10-May-1997 for PLD L4-5 and  reoperated for recurrence at the same site for drop foot 29-August-2004 for the same sciatica.

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On examination: the patient still has weak drop foot , but without sensory deficit. SLRS was 80 degrees in the left.

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MRI lumbar spine performed 04-June-2008 showing de novo PLD L3-4 in the left side with far-lateral extrusion, occluding the left L4 root foramen.

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Laminectomy L3 and removal of the remnant of L4 was performed. Foraminotomy of left L4 root was achieved. The left far-lateral extrusion was removed and meticulous cleaning of L3-4 was performed from the left. Image-intensifier was used to speed the operative management.

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Smooth postoperative recovery and the power of the left foot still the same.

Comments

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The recurrence rate in this case is below the average, because the disc space height is minimal.

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Recurrent disc leave scar, for what dissection must be started from the healthy tissues.

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Good imagination of the extrusion must be kept in mind so as not to miss the extrusion.

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