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26-JUNE-2010  AMEEN HAFEZ MUHAMED  38 YEARS  HUGE BILATERAL EXTRUDED DISC L4-5 MORE TO THE RIGHT.

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 23-June-2010 complaining of LBP for 10 years which disappeared, then the last 2 months got agonizing left sciatica and bilateral sciatica the last month more the right.

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On examination: the patient is limping with scoliotic stance. SLRS was 5 degrees with pain both sides with weak dorsiflexion right foot 3/5 and planterflexion 3/5.

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MRI lumbar spine done 24-June-2010 showing huge extruded disc L4-5 with bilateral extrusion more to the right with sacralization of L5.

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Using image-intensifier the L4-5 level was confirmed and bilateral flavotomy of L4-5 was done and bilateral removal of the extruded disc, starting from the right then from the left, after what the roots became lax. Bilateral cleaning of the disc space of L4-5. 

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Routine closure of the wound and smooth postoperative recovery with improvement of the power of right foot.


Comments

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The patient had very huge disc with agonizing pain. The neurological deficit was accompanied with the huge extrusion in the right.

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The expected postoperative recurrence is below 7%, because the disc space is shallow.


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