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The patient came to the clinic 29-November-2006 complaining
of
LBP for 5 months. The last 2 months, he
progressed severe right sciatica. MRI performed 27-September-2006
showed extruded disc L5-S1 with right downward migration. On examination: the patient was limping with scoliotic stance
with SLRS 45 degrees in the right, weak dorsiflexion all toes right
foot with hypalgesia both L5 and S1 territories right foot.
Right L5-S1 hemiflavotomy with right S1 root foraminotomy were
preformed and the extruded disc material was removed in several pieces
lateral to the axilla. The defect in the annulus fibrosis was
relatively
small and the disc space was cleaned from the right until the
sequestrated material was removed. Maximal cleaning was
achieved.
Smooth postoperative recovery.
Comments:
1. The disc space is relatively narrow and the defect in the
annulus fibrosis was small. The expected recurrence is
relatively lower than the usual.
2. The root was adherent to the extruded disc with presence of
soft disc material. This indicate, that his problem was acute upon
chronic process. |
