Marcio R.R. Cunha Ramalho
Senior Instructor The Clinic Trauma Center, Brazil
Title: Lumbar Nerve Root Entrapment Treated Under Full Endoscopic Interlaminar Approach
Biography
Biography: Marcio R.R. Cunha Ramalho
Abstract
We have a lot of causes to entrap the lumbar nerve roots, bringing sciatica as a major symptoms, these entrapments can be a result from many etiologies such as intervertebral disc herniation , spinal stenosis , the formation of osteophytes and the fibrous adhesive entrapment ( ).We present a A 58-year-old woman presented to our clinic in march 2017, complaining of severe right sciatica her complains were aggravated by walking and coughing and prolonged sitting position, she was also experienced numbness and a tingling sensation in the lateral portion of her right foot .On physical examination the straight leg raise test was positive only in her right side ,with a 45 angle raise, her Achilles tendom reflexe was abolished . The Lumbar MRI showed no remarkable signs of nerve block in the level L5/S1 to explain the origin of the pain . We've made a nerve root block using 01 cc of lidocaine of the right S1 root with complete relief of the symptoms for eight hours . In face a positive result of the blockage test, we´ve done a full endoscopy interlaminar approach .We've made the procedure under the steps of the full endoscopic interlaminar approach by Rueten technical ( ). After open the yellow flavum ligament we could see a total S1 root entrapment by fibrous adhesive tissue with no signs of the S1 root ,after some manipulations we could see how entrapted was the nerve root with some surgical manueveres using the disector and scissor punch , we could liberate the nerve root until its entrance in the foramen .The procedure took around 34 minutes with a patient hospital discharge around six hours, using a single pain killer to control the lumbar back pain in the first 24 hours .