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13-NOVEMBER-2008  ALI HASAN AMER  37 YEARS  HUGE EXTRUDED DISC L4-5 WITH UPWARD MIGRATION MORE TO RIGHT.

Anamnesis:

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The patient came to the clinic 11-November-2008 complaining of LBP for 2 months with right sciatica with numbness of the second and third toes right foot.

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The patient suffered RTA 15 years ago after what he started to complain of LBP.

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MRI lumbar spine performed 02-November-2008 showed huge extruded disc L4-5 with upward migration more to the right.

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On examination: the patient is limping with exaggerated scoliotic stance, with weak planterflexion both feet 4/5 and dorsiflexion -4/5 .

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Skeletonization of L4 and L5 laminae revealed fracture of isthmi both sides. Laminectomy of L4 was performed the upper edge of L5 with bilateral foraminotomy. The bony extrusion was removed from both sides and meticulous bilateral cleaning of L4-5 disc space was achieved. The harvested bone was milled and the bony dust was impacted in the disc space.

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Smooth recovery with prompt improvement of the power of both feet.

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

Comments

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The patient denying recent injury to the spine. It could be caused by the old RTA 15 years ago. These finding of fracture of both isthmi were discovered during surgery.

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All these elements must be corrected during surgery. Instead of using transpedicular fixation, the bone dust was impacted to the disc space and the patient will be kept in corset for 6-7 months after surgery.


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Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

     

  

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