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The patient came to the clinic 16-April-2006 complaining of
left sciatica for 3 months down to S1 territory. She could
walk only 100 meters, after what the pain escalating, making her
unable to proceed. She is a known rheumatoid patient in prednisolone
twice daily for 26 years. MRI performed
28-January-2006 showing very huge extrusion of
L5-S1 with left downward migration. On examination: SLRS was 90
degrees in both sides with weak
dorsiflexion and planterflexion of the left foot. She was
advised to undergo surgery and given pain-killers and Oscal-d for
osteoporosis.
Left L5-S1 flavotomy with left S1 root foraminotomy was done
and the extruded disc was removed in several pieces from under the
axilla in several huge pieces. The disc material was severely
adherent to the root and it was necessary to use sharp dissection to
release the root from the disc material. After removing the big part
from under the axilla, the root was shifted medially and the disc
space was cleaned meticulously.
Routine closure of the wound. Smooth postoperative neurological
recovery. |
