Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .
04-AUGUST-2004 HISHAM AL-RAHAHLEH 52 YEARS
EXTRUDED DISC L4-5, MORE TO THE RIGHT.
The patient is a doctor gynecologist came
to the clinic 01-August-2004 complaining of LBP
with right sciatica for 1 week. MRI lumbar spine performed
28-July-2004 showing huge extruded disc L4-5,
more to the right.
On examination: The patient is limping with
exaggerated scoliotic stance. SLRS was 20
degrees in the right and 80 degrees in the
left with pain. There is
weak dorsiflexion right foot 3/5 with hypalgesia
right L5 and S1 territories.
both L5 roots with
removal of the huge extrusion lateral to the axilla
from the right side. After
that, the root became lax and right sided
intradiscal cleaning L4-5 disc space was done.
Bilateral cleaning of L4-5 was proceeded. The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. A fat in pedicle was
transferred from the subcutaneous layer and
covered the exposed parts of the dura and roots
to minimize postoperative scarring. Routine
closure of the wound. Smooth postoperative
recovery. The power of the right foot became
normal. He was
sent to the ward.
The patient came to the clinic 14-August-2004
with clean wound and SLRS 90 degrees both sides
without pain and still having mild weak
dorsiflexion right foot 4/5. Advised to keep in
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still relatively not shallow.