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NADYA HASHEM SALHAB 50 YEARS SPONDYLOLISTHESIS
l4-5 AND L3-4.
The patient came to the clinic 26-July-2017
complaining of LBP for 3 years with right sciatica for
down to gastrocnemius not reaching below the
ankle. The patient is a known hypertensive for 3
years under treatment.
On examination, the patient is limping with
was 30 degrees with pain in the right and 70
degrees in the left. There is weak dorsiflexion
right foot -4/5.
The patient was sent for investigations and MRI
lumbar spine performed the same day, showing
spondylolisthesis L4-5 and bulge L3-4. Dynamic
studies confirmed the presence of II grade
spondylolisthesis L3-4 and L4-5. lab
investigations showed Hb 11.4 mg/L WBC 11.5 and
ESR was 60 mm/h. The patient was given
antibiotics to minimize postoperative infection
and she has allergy to Dalacine. Cardio
consultation reporting low risk for G.A.
Skeletonization of L3,4,5
until the lateral proccessi were under vision.
Transpedicular reduction and fixation of L3,4,5
was achieved using OSImplant system with 2
polyaxial 5.5x45 mm to L5 and 4 monoaxial same
sizes to L4 and L3 levels. During bony
dissection, it was noticed that the right
lateral mass of L4-5 suffered fracture for what,
she was complaining of right sciatica. Since
there was no stenosis nor proper extrusion it
was decided not to violate the neural
structures. Routine closure of the
Smooth postoperative recovery. The power of
the right foot normalized and she was sciatica free.
She was sent to the ward.
The patient has spondylolisthesis at 2
levels. Fusion must include