Ahmed Azab , Adel Hanafy , Alaa Essa, Khaled Aref, Hesham ...

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Menoufiya Medical Journal 194 Surgical Aspects in Management Vol. 21 No . 2 July 2008 Ahmed Azab et al., Table (3): Clinical picture: Low back pain was the main complaint followed by the crural and anterior thigh pain. The most dominant clinical sign was the positive femoral stretch test (70%), followed by motor weakness in (60%). The straight leg raising test (SLRT) was positive in 30% only with concomitant lower lumber disc affection: Symptoms No. of patients Percentage Low back pain (L.B.P) 30 100% Anterior thigh pain 27 90% Sensory changes 15 50% Claudication 12 40% Sphincteric disturbances 3 10% Signs Back signs 15 50% Positive femoral stretch test 21 70% Positive SLRT 9 30% Reflex changes 18 60% Sensory changes 15 50% Motor weakness 18 60% Table (4): The level of disc prolapse, the most frequent level affected was the L2-3 level, followed by Ll-2 level and lastly D12-L1 level. Level No of patients Percentage D12-L1 3 10% L1-L2 9 30% L2-L3 18 60% Total 30 100%
Menoufiya Medical Journal 195 Surgical Aspects in Management Vol. 21 No . 2 July 2008 Ahmed Azab et al., Table(5): MRI and CT findings: MRI and CT findings No. of patients Percentage Diffuse annulus disc bulge 24 80% Central hard disc protrusion 6 20% Indentation ofthecal sac 30 100% Encroachment on lateral recess and nerve root exit foraminae 24 80% Caudal migration of disc prolapse 3 10% Lumbar spondylo degenerative changes 18 60% Concomitant lower lumbar disc prolapse 9 30% Concomitant lower lumbar canal stenosis 18 60% Sagittal stenosis 18 60% Table (6) Operative procedures: 60% of cases were treated with laminectomy uniletral facetectomy and discectomy at the involved level. 30% of cases were treated with laminectomy without discectomy due to hard spondylotic bar. In 3 cases constituting 10% at all cases, laminectomy, bilateral facetectomy, pediclectomy and discectomy was done followed by transpedicular fixation. Operative procedures No. of patients Percentage Laminectomy without discectomy at involved level. 9 30% Laminectomy, unilateral facetectomy with discectomy at involved level Laminectomy, bilateral facetectomy with pediclectomy discectomy and transpedicular fixation. 18 60% 3 10%
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