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The patient came to the clinic 26-June-2005 with difficulty in
walking and left sciatica for 8 days. She was diagnosed as
having OA left knee for 2 years and she is a known diabetic
with IHD. She underwent balloon dilatation of the coronaries 2001.
On examination, she had hypalgesia of the left L4 dermatome with
weak both quadriceps muscles 4/5 both sides. She was sent for
investigations and MRI of the lumbar spine showed huge
extrusion L3-4 left side and she was advised to undergo
surgery. The patient escaped, then appeared 13-May-2006 with new
MRI showing LCS L3-4 and L4-5 with the old extrusion calcified
and participating with the stenosis. Her condition continued to
deteriorate and she got dripping of urine for the last 6
months with the same hypalgesia and weak all muscles left
lower limb. The patient was pale and her Hb was 8.4
µg/ml for what she was given 2
units of blood and she was operated.
Laminectomy of L3-4 and partial of L2-5 (sacralized L5) was
performed and all the compressive elements were removed. The left L4
root was inspected and foraminotomy for this compressed root was
performed. Inspection of the L3-4 disc revealed that it is not
mobile and no need to violate it.
Immediate postoperative recovery with recovery of her weakness. |
