SURGICAL TREATMENT INDICATIONS IN NERVE ROOT COMPRESSION BY HERNIATED LUMBAR DISC
Abstract:
Degeneration of intervertebral discs is the consequence of aging and inevitable minor spinal
traumas. Back pain is among the most frequent medical complaints, affecting almost 80% of the adult
population. We present the case of a 48 year old male admitted with classical clinical features of
sciatica, with associated motor deficit affecting the anterolateral calf muscles, extended gradually over a
period of 6 months. Magnetic resonance imaging (MRI) of the lower spine revealed inferior migration of
the herniated L4-L5 lumbar disc, with L5 nerve root compression. We performed right L4-L5
interlaminary approach, right L5 foraminotomy and ablation of the right L4-L5 herniated disc. There
was almost immediate complete regain of muscle strenght in the lower right limb, with dramatical
decrease of nerve root pain. Thus, we suggest that surgery should systematicaly be considered as an
option, as this positive outcome defied the correlation between duration of preoperative weakness and
extent of neurological recovery.
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