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Multigen RF lesion generator .

 

18-JUNE-2009  FADY FAKHRY QOZAH  33 YEARS  EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 17-June-2009 complaining of LBP for 2 years with left sciatica the last 4 months with exacerbation of sciatica the last month with numbness left foot.

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MRI lumbar spine performed 15-June-2009 showing extruded disc L4-5 with left downward migration and sacralization of L5.

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On examination: the patient was limping with weak dorsiflexion left foot 4/5 and exaggerated scoliotic stance. SLRS was 30 degrees with pain in the left.

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Using image-intensifier, the L4-5 level was identified with the use of methyline blue. Left L5 foraminotomy was performed after performing left L4-5 partial flavotomy. The extruded disc was removed lateral to the axilla and meticulous cleaning of L4-5 disc space was achieved from the left. Routine closure of the wound

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Smooth postoperative recovery with improvement of the power of the left foot.

Comments

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The patient still having considerable height of the disc space, which make the expectation of recurrence higher than 7%.

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So as to avoid dramatic clinical deterioration in case of possible recurrence the foraminotomy was extended more down to have ample to the root in case of recurrence.

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