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Multigen RF lesion generator .
08-AUGUST-2004 HUDA ABDEL-RAHMAN JALAFNEH 40
YEARS HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
The patient came to the
clinic 04-August-2004 with agonizing LBP with
for 3 weeks, down to S1 root
territory. MRI lumbar spine
done 02-August-2004 showing huge extruded disc
L5-S1 with left downward migration. She had LBP
for 5 years with intermittent course.
On examination, the patient in agonizing pain,
limping with exaggerated scoliotic stance with
drop left foot and weak dorsiflexion right foot 3/5
and planterflexion both feet with hypalgesia
left L5 and S1 territories. SLRS was 20
degrees with pain left side and 45 degrees
right side with
Foraminotomy right S1
root was achieved.
Right sided intradiscal cleaning L5-S1 was
performed. The patient was put in Reverse
Trendelenburg position with Valsalva maneuver
and hyperventilation. No CSF leak. The epidural
fat was transferred to the left axilla area. A fat was
harvested from the
subcutaneous layer with pedicle and transferred and covered the exposed parts
of the root to minimize postoperative
scarring. The ligamentum flavum returned back in
place. Routine closure
of the wound.
Smooth postoperative recovery. The power of
the right foot normalized.
came to the clinic 18-August-2004 with clean wound and no motor,
nor sensory deficit.
There is still an
estimated postoperative recurrence around 7%,
because the disc space is still not completely