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18-MAY-2010  FATIMA IZZAT ABDEL-HADY  52 YEARS  EXTRUDED DISC L5-S1 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 29-December-2009 complaining of LBP for 9 years with right sciatica for one year down to the heel of the right foot.

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MRI lumbar spine performed 16-September-2009 showing extruded disc L5-S1 central more to the right.

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On examination the patient can walk more than 1Km with SLRS 80 degrees both sides with weak dorsi and planterflexion right foot 4/5.

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The patient was advised to keep in conservative measures and if she deteriorate in the future then to reevaluate her condition.

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The patient then came 12-May-2010 claiming that her condition is deteriorating and the weak planterflexion right foot became 3/5 with hypalgesia right S1 root territory. SLRS was 75 degrees in the right with pain. The patient is limping with exaggerated scoliotic stance.

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The patient was sent to new MRI which was performed and demonstrating extruded disc L5-S1 with right foraminal occlusion.

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Right L5-S1 hemiflavotomy with right S1 foraminotomy was achieved. The extruded disc was removed after what the right S1 root became lax. Further meticulous cleaning of L5-S1 space was performed from the right side.

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Smooth postoperative recovery and the power of the right foot became normal..


Comments

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The patient  had extruded disc at the start, not convincing for surgical treatment. Later escalation of the events shifted the decision in favor to surgical treatment.

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In this case the disc space still not shallow, that the estimated postoperative recurrence is around 7%.


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