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22-AUGUST-2011  RIFAAT ABDEL-MAJEED QAITOQA  73 YEARS  LUMBAR CANAL STENOSIS DUE TO RUPTURED GANGLION RIGHT SIDE.

Anamnesis

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The patient came to the clinic 15-August-2011 complaining of LBP for 1 month with weak right lower limb after lifting heavy object. He is using walker for 2 weeks.

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MRI lumbar spine done 13-August-2011  showing ruptured ganglion of the right L3-4 with severe compression of the lumbar canal at this area.

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On examination: the patient in wheel chair, that it was impossible to evaluate Romberg and scoliotic stance. There is weak dorsiflexion right foot -3/5, left foot 3/5, planterflexion right foot 3/5, left foot +4/5. Hypalgesia right L5 and S1 territories. SLRS was 90 degrees both sides without pain.

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Using C-arm, the L3-4 level was identified and partial flavotomy around the suggested ganglion was undertaken at L3-4. After removing sufficient amount of the flavum, a blue mass appeared, which was hemorrhagic and stuck to the dura, but separable. Total removal of the mass, which was arising from the right L3-4 facet was achieved, after what the dura became lax and free. The mass was sent for histological verification, to rule out malignancy.

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


 

 

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

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Rupture of the ganglion from the facets of the vertebral column is not uncommon, but most of them can be treated conservatively.

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In this case, surgical intervention was mandatory, to prevent the escalation of further deterioration of the neurological status.

 


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