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19-JUNE-2010  LINDA SABRI TAIEM  31 YEARS  HUGE EXTRUDED DISC L5-S1 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 clinic 25-August-2009 complaining of LBP for three years with left sciatica for one month with numbness of the second and third toe left foot. The patient at that time, had SLRS 70 degrees in the left with exaggerated scoliotic stance with weak dorsiflexion 3/5 and planterflexion 4/5 of the left foot and hypalgesia below the left knee. MRI done 31-December-2007 showed extruded disc L5-S1 left side.

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The patient was sent to new MRI, which was done 08-September-2009 showing increase of the extrusion.

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The patient then came 17-June-2010 with new MRI performed 17-June-2010 showing very huge extrusion of the disc with agonizing pain urging for surgery. The patient is unable to walk or set of sleep supine. She has exaggerated scoliotic stance with drop left foot1/5 dorsiflexion and weak planterflexion both feet 4/5.

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Using image-intensifier (The patient has lumbarization of the sacrum), a 3-cm incision was done and foraminotomy of the left S1 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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The patient had an extrusion that all the time is increasing in size. The patient was reluctant for surgery, but when the pain made her unable to live, she came urging for surgery.

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The estimated recurrence rate in this case is below 7%, because the disc space is shallow.


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