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Multigen RF lesion generator .

14-JUNE-2010  SALMA RASHEED SALEH  52 YEARS  RECURRENT PLD L4-5 LEFT SIDE.

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 clinic13-June-2010 complaining of LBP with left sciatica for 45 days with exacerbation of both the last 10 days.

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The patient was operated by me 1996 for PLD L4-5 for left sciatica. and was doing well. She was also diagnosed and treated by me 2 years later for MS.

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MRI of the lumbar spine performed 13-June-2010 showed recurrence of disc of L4-5 with complete obliteration of the left L5 root.

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On examination; the patient on agonizing pain urging for surgery. She cannot stand for evaluation of scoliotic stance. SLRS was 40 degrees in the left with pain. There is weak dorsiflexion left foot -4/5.

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The upper part of the old incision was refreshed and scarolysis of the left L5 root was achieved. The extruded fragments were removed lateral to the axilla after what the root became lax and free. Further cleaning of the disc space was done from the left side.

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Routine closure of the wound and smooth postoperative recovery with improvement of the power of the left foot.


Comments

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Recurrence of the lumbar disc still consisting a major problem, which up to now is not resolved. It could happen even after 20-30 years after surgery as in this case.

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The expected re-recurrence in this case is minimal because the disc space is shallow.

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PEEK is no more adopted by us because it has many problems and causing with all patients reactionary osteomyelitic changes of the adjacent vertebrae, which needs long-term treatment and sometimes removal of the sphere.


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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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