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13-APRIL-2010  SALEH ABDALLAH AL-SAADY  70 YEARS  LUMBAR CANAL STENOSIS WITH OLD EXTRUDED DISC L4-5 WITH RIGHT FORAMINAL OCCLUSION.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

 

Anamnesis

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The patient came to the clinic 10-April-2010 complaining of LBP with walking difficulty for 10 years  with exacerbation last year with bilateral sciatica more the right.

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MRI lumbar spine performed 21-November-2009 showed severe lumbar canal stenosis L4-5 with with extruded disc L4-5.

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On examination: the patient is dragging the right lower limb with weak dorsiflexion left foot 4/5 and right foot 3/5.

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The patient was advised to repeat MRI of the lumbar spine, which was done 11-April-2010 was a bad quality one and then repeated 12-April-2010 which confirmed the presence of the stenosis and the extrusion with right foraminal occlusion.

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Decompressive laminectomy L4 and partial of L5 was performed and the annulus fibrosis of L4-5 was checked for fresh extrusion. It was negative both sides. Foraminotomy of the left L5 root was performed easily, but it was necessary to extend foraminotomy for 17 mm along the right L5 root to achieve acceptable release. Considering that the extrusion at the right side was glistening and not movable with calcified surface, it was decided not to violate the disc space.

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Routine closure of the wound.

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Smooth postoperative recovery, with full recovery of the power of both feet.


Comments

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Lumbar canal stenosis is a progressive disease and the sooner the better the outcome.

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Considering that the right L5 root was badly compressed, postoperative recovery was anticipated after release.


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