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Multigen RF lesion generator .

 

21-JUNE-2009  HASAN ABEDRABOH MUHAMED  40 YEARS  HUGE EXTRUDED DISC L4-5 WITH LEFT FAR DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 15-June-2009 complaining of left sciatica the last 6 months with exacerbation of sciatica the last 3 days making him unable to sleep.

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MRI lumbar spine performed 02-April-2009 showing extruded disc L4-5 with left downward migration.

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On examination: the patient was limping with exaggerated scoliotic stance and weak dorsiflexion left foot 4/5 . SLRS was 90 degrees with pain in the left. The patient was sent to another MRI which showed further enlargement of the disc.

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Using image-intensifier, the L4-5 level was identified. Left L5 foraminotomy was performed after performing left L4 hemilaminectomy. The extruded disc was removed from under the axilla and meticulous cleaning of L4-5 disc space was achieved from the left lateral to the axilla. 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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[2009] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved