Monday, September 10, 2007

Hey Clinic Surgery Sep 6 2007: L5S1 microdiscectomy for huge free fragment disc herniation

Thursday afternoon after our five hour anterior/posterior spinal reconstruction, I performed a 45 minute microsurgery to remove a huge free fragment disc from a young gentleman who was in absolute agony for 3 weeks with radiating leg pain, trouble standing and walking, and leg weakness. His MRI showed a huge L5S1 disc herniation with huge free fragment crushing the S1 nerve root.

His MRI is shown above.

I found the disc using microsurgical techniques crushing the nerve root. I incised over the disc herniation, and pulled out a huge piece of white disc material which came out like a big hunk of “crab meat”. The S1 nerve root immediately looked better, not stretched over the huge mound. The S1 nerve root was so tightly stretched over the herniation that I actually had to take the disc out medial to the nerve root, rather than laterally, since the S1 nerve root was so taught over the herniation. A picture of the offending disc fragment is shown in a little jar – a small piece of tissue, but pushing on a very sensitive part of the body.

Postoperatively the patient did great, with excellent relief of the pain. He went home the next day walking well.

5+ years ago I suffered with a C67 disc herniation for over a year, and finally had it removed when it was unbearable.

I will never forget waking up in recovery room with my L arm pain and shoulder pain gone. What a relief --- Like a lion getting the thorn removed from the paw!!

It is nice to have a balance in our weekly OR and clinic schedule, helping people with everything from a little bit of advice for a home exercise program, up through injections, microsurgery, small decompression and fusions, major scoliosis surgery, and even revision scoliosis and spine surgery. Last week was a great week in this regard.

Lloyd A Hey, MD MS

The Hey Clinic for Scoliosis and Spine Surgery

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