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14-NOVEMBER-2010  AREF DEYF-ALLAH ABU-JAMOUS  51 YEARS  HUGE RECURRENT PLD L4-5 WITH RIGHT DOWNWARD MIGRATION.

Anamnesis

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The patient was admitted to Shmaisani hospital 12-November-2010 with severe agonizing right sciatica for 2 days. The patient was operated by me 24-November-2004 for huge extruded disc L4-5 right side.

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MRI lumbar spine performed 13-November-2010 showing huge recurrent PLD L4-5 with right downward migration.

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On examination: The patient  is in agonizing pain, that cannot find a position in the bed to decrease his pain. There is weak dorsi and planterflexion right foot 3/5 and hypalgesia right L5 and S1 roots territories.

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Right L4-5 scarolysis with foraminotomy right L5 root was performed. The extruded disc was attacked lateral to the axilla and it was removed in 2 big pieces, after what the root became lax, but with scars. The disc space of L4-5 was shallow and empty.

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Routine closure of the wound. Smooth postoperative recovery and improvement of the power of right foot.


Comments

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The patient has new extrusion with severe compression upon the right L5 root, which is so big, that the patient is in agonizing pain. Surgery is the only solution to such situation.

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The estimated recurrence rate is below 7% because the disc space is shallow.

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Notice: Head injuries and very urgent surgeries are also escaped from the plan .

 

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