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26-JULY-2009  NADA MAHMOUD AL-ATRASH  60 YEARS  EXTRUDED DISC L3-4 WITH LEFT 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 22-July-2009 complaining of LBP with left sciatica for 4 years with exacerbation the last 10 days.

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She has left blind eye with keratitis since childhood. She is a known diabetic for 6 months and hypertensive for 10 years.

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MRI lumbar spine performed 19-July-2009 showing extruded disc L3-4 with left downward migration. MRI of the brain done 14-July-2009 showing scattered old lacunar infarctions.

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On examination: the patient is limping with scoliotic stance, SLRS was 90 degrees both sides and weak dorsi and planterflexion left foot 3/5.

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Using image-intensifier the L3-4 level was identified and methylene-blue was used to keep the tissue marking. Left L3-4 hemiflavotomy with extended exposure the left L4 root was performed inferiorly. The downward migrating big disc material was removed in several pieces lateral to the axilla. Left sided cleaning of the disc space of L3-4 was achieved. 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 expected recurrence in this case is around 7% and PEEK nucleus replacement sphere was not in favor, because of osteoporotic bone.


Back Up!

Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

     

  

[2009] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved