SURGICAL TREATMENT INDICATIONS IN NERVE ROOT COMPRESSION BY HERNIATED LUMBAR DISC

摘要

Degeneration of intervertebral discs is the consequence of aging and inevitable minor spinaltraumas. Back pain is among the most frequent medical complaints, affecting almost 80% of the adultpopulation. We present the case of a 48 year old male admitted with classical clinical features ofsciatica, with associated motor deficit affecting the anterolateral calf muscles, extended gradually over aperiod of 6 months. Magnetic resonance imaging (MRI) of the lower spine revealed inferior migration ofthe herniated L4-L5 lumbar disc, with L5 nerve root compression. We performed right L4-L5interlaminary approach, right L5 foraminotomy and ablation of the right L4-L5 herniated disc. Therewas almost immediate complete regain of muscle strenght in the lower right limb, with dramaticaldecrease of nerve root pain. Thus, we suggest that surgery should systematicaly be considered as anoption, as this positive outcome defied the correlation between duration of preoperative weakness andextent of neurological recovery.