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24-AUGUST-2008  FATTAH YOUNIS KHALAF  37 YEARS  HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 11-August-2008 complaining of LBP for two years with left sciatica.

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MRI performed 01-March-2008 showed huge disc L4-5 central with left downward migration.

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On examination: the patient is limping with scoliotic stance with hypalgesia below the left knee without involvement of left S1 territory. There is profound weak dorsiflexion left foot 3/5.

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MRI was repeated 12-August-2008 and confirmed the presence of the previous data.

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Bilateral foraminotomy of both L5 roots was performed and radical removal of the ligamentum flavum. The extruded disc was removed from under the left L5 root lateral to the axilla in several pieces. The centrally extruded hard disc was removed from both sides.

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Routine closure of the wound and smooth postoperative recovery.

Comments

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The patient has very shallow disc space, which indicate that the estimated recurrence rate in this case is around zero.

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