PMC5259598_01
Preoperative MRI scan showing (A) sagittal, (B) axial T2W, (C) axial, and (D) sagittal gadolinium enhanced sequences showing the L2-L3 complete disc extrusion with an anterior-to-posterior circumferential course of the sequestered disc.
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fig1
Intraoperative picture showing (A) L2 nerve root, (B) dural sac, (C) L3 nerve root, and (D) the posterior extruded segment.
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fig2
Broomfield, CO, USA), and L2 and L3 nerve roots adhesiolysis. Bony removal was intentionally generous because the sequestration was voluminous and the risk of performing incidental tractions or surgical traumas on nerve roots was high; furthermore, left L3 nerve root foraminotomy and adhesiolysis were difficult to perform with a standard approach for a simple L2-L3 discectomy (Figure 2).
A postoperative MRI scan demonstrating complete resection of the sequestered disc material. Note the decompression of the dural sac and nerve root. L2-L3 arthrectomy and interspinous fixation at the same level were performed.
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fig3
During the first postoperative day, a routine postoperative lumbar MRI scan was performed (Figure 3) and demonstrated a complete sequestrectomy and successful decompression of the nerve roots.