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Multigen RF lesion generator .

23-FEBRUARY-2010  ROLLA JERYES HADDADIN  37 YEARS  HUGE EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL AND RIGHT DOWNWARD MIGRATION.

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 21-February-2010 complaining of LBP for 15 years of intermittent course. 25-January-2010 got severe right sciatica with exacerbation of LBP and numbness lateral aspect of the right foot.

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MRI of the lumbar spine performed 13-February-2010 showing extruded disc L5-S1 with right lateral and downward migration.

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On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 30 degrees with pain in the right. Hypalgesia right L5 and S1 roots. There weak planterflexion 2/5 and dorsiflexion 3/5 of the right foot.

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Foraminotomy of right S1 root was achieved and the extruded disc with downward migration was removed in several pieces. Upward inspection revealed another extrusion at the disc space of L5-S1 level, which was also removed and right sided cleaning of the shallow disc space was performed. It was possible to see the right L5 root and the right S1 root was free for 12 mm down of the axilla . The root was swollen.

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Routine closure of the wound.

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Smooth postoperative recovery, and the power of the right foot improved.


Comments

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The disc space was shallow, for what the estimated recurrence rate is low and there is no need for insertion of the Satellite PEEK sphere.

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The swollen root was inspected carefully to avoid missing intradural penetration of disc fragments.


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