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27-DECEMBER-2010  SAWSAN ABDEL-RAHEEM AWAWDEH  40 YEARS  HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.

Anamnesis

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The patient came to the clinic 27-December-2010 complaining of agonizing left sciatica for three days, depriving her sleep during this period.

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MRI of the lumbar spine performed 27-December-2010 showing huge extruded disc L5-S1 with left downward migration.

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On examination: The patient  is unable to stand to evaluate her stance and walking. She could sleep with difficulty supine to evaluate the SLRS which was 70 degrees with pain in the left side. There is weak dorsiflexion 3/5 of the left foot. There is numbness of the entire left foot, but with preserved sensation.

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Foraminotomy of left S1 was performed and subaxillary removal of the huge extrusion was achieved. The disc fragments was hard and with sharp edges. The axilla was then shifted medially and intradiscal cleaning of L5-S1 was performed. The epidural fat was maximally preserved to prevent scar formation.

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Routine closure of the wound. Smooth postoperative recovery with normalization of the power of the left foot and disappearance of left sciatica.


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

Comments

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The patient has very huge extruded disc L5-S1 with downward migration. Conservative treatment will not succeed.

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The recurrence rate in this case is below 7% because the disc space is relatively shallow.


 

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