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12-APRIL-2008  MAHMOUD MUHSEN AL-KOOZ  40 YEARS  EXTRUDED DISC L4-5 LEFT SIDE.

Anamnesis:

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The patient came to the clinic 10-May-2003 complaining of both shoulders pain and neck and right upper limb pain. The patient was treated conservatively and escaped until 08-April-2008 came with LBP for 2 months and left sciatica.

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SLRS was 70 degrees in the right and 30 degrees in the left with pain. Limping when walking and exaggerated scoliotic stance. He had weak dorsiflexion both feet, more in the left and planterflexion left foot.

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MRI of the lumbar spine performed 09-April-2008 showed extruded disc L4-5 with left foraminal occlusion.

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Left L4-5 hemiflavotomy with left L5 root foraminotomy was done. The extruded disc was removed lateral to the axilla and left sided cleaning of the L4-5 space was achieved.

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Routine closure of the wound with smooth postoperative recovery.

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Considerable improvement of the power of the left foot.

Comments

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The disc space height is still considerable, for what meticulous cleaning was performed to decrease the expected recurrence rate, which still remain above the average.

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