Disputable Problems of Surgical Tactics in Complicated Forms of Discogenic Lumbosacral Radiculitis

A.I. Verkhosvky

(Dzhanelidze Research Institute of Emergency Care, Saint Petersburg)

Female patient T., aged 46, was admitted to the Institute with pain in the lumbar spine, right leg, urine retention and fever. She had been suffering from lumbar pain during 6 months. The patient developed urination disorders and high temperature in spite of conservative treatment, including paravertebral blockade. Examination revealed extensive phlegmon of the right lumbar area. MRI showed sequestrated hernia of the intervertebral disk of L4-5 with compression of the root of L5 and liquor circulation disturbance. The patient was operated on the same day. The operation included opening and emptying of phlegmon, fenestration of L4-5, sequester removal, through drainage of a wound. Regression of pelvic dysfunction, normalization of temperature, wound healing by the first intention were watched. The patient was reoperated in 20 days. Conventional diskectomy by curettage and root revision were made. She was discharged on the 36th day after admittance. There were no complaints.

The demonstration purpose was to discuss problems of surgical tactics in combination of neurologic and inflammatory complications of lumbar osteochondrosis.