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08-APRIL-2002 SAMIHA ISA SHISHAN 72
YEARS EXTRUDED DISC L4-5 RIGHT SIDE AND BULGE L5-S1.
Anamnesis
The patient came to the clinic 02-April-2002
complaining of LBP for 1 year and right sciatica
for 2 months. MRI performed recently showing
extruded disc L4-5 wide-based more to the right
with bulge L5-S1.
On examination: The patient is in agonizing pain
with right sciatica. SLRS was 10 degrees with
pain in the right. There is weak dorsi and
planterflexion right foot with hypalgesia right
L5 and S1 territory.
Decompressive laminectomy L4-5 with right
extended L5 foraminotomy with removal of the
extrusion lateral to the axilla and right sided
cleaning L4-5 disc space. Foraminotomy of the
right S1 root with inspection of the bulge of
L5-S1. It was decided not to violate the disc
space. The patient was put in Reverse
Trendelenburg position with Valsalva maneuver
and hyperventilation. No CSF leak. Routine
closure of the wound.
Smooth postoperative recovery.
The power of the right foot improved.
She was sent to the ward.
Follow Up
The patient came to the clinic 18-April-2002
with clean wound and sciatica free and normal
power and sensation right foot.
Comments
There is still an estimated postoperative
recurrence around 7%, because the disc space still not
shallow.
In retrospective analysis, it was unnecessary
to explore the L5-S1 level. (12-April-2021).
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