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21-JUNE-2010  RABI'AH ABDEL-HAFEZ AL-ATRASH  58 YEARS  SEVERE LUMBAR CANAL STENOSES L4-5 WITH EXTRUDED DISC RIGHT 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 16-June-2010 complaining of LBP for 20 years with intermittent right sciatica for two months down to the right L5 territory.

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On examination: the patient is limping with scoliotic stance. She has rheumatoid hands. SLRS was 40 degrees with pain in the right with weak dorsiflexion right foot 3/5 and left foot 4/5. There was analgesia of the right L5 and hypalgesia of the left S1 territories.

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MRI lumbar spine done 09-June-2010 showing severe lumbar canal stenosis with extrusion of L4-5 disc compressing the right L5 root.

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Decompressive laminectomy of L4 and partial of L5 was done with bilateral flavotomy L3-4. Foraminotomy both L5 roots was done. The right L5 root was inspected and rounded extrusion compressing the root was seen and removed. The surface of the annulus fibrosis of L4-5 was inspected and it was decided not to violate the disc space.

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Routine closure of the wound and smooth postoperative recovery with improvement of the power of both feet.


Comments

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The patient had lumbar canal stenosis, which required surgery by itself. During that the extruded disc fragment anterior to the L5 axilla was also removed.

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The defect of the annulus fibrosis was microscopic, for what it was decided not to violate the intradiscal structure.


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