Patient: a 72-year-old woman. BMI: 26.6 kg/m².
Clinical findings
Pain along the anterolateral right thigh and front of the right lower leg had lasted more than six months. Preoperative intensity was 8–10/10 on the VAS. Right knee extension weakness was present, graded 4/5 on the MRC scale.
The patient had received repeated courses of conservative treatment. She had not previously undergone lumbar spine surgery.
Preoperative imaging
MRI: right-sided extraforaminal L4–L5 disc herniation. Clinical diagnosis: right L4 radiculopathy.
Surgical treatment
Right-sided biportal endoscopic L4–L5 discectomy using BESS/UBE was performed through a transforaminal approach. There were no intraoperative complications.
Postoperative course
The next day, right leg pain was 5/10 on the VAS. Follow-up MRI was performed.
At one week, pain intensity was 4/10 on the VAS. Right knee extensor strength remained 4/5 on the MRC scale.
Neuropathic symptoms appeared during the same period: burning pain, tingling and pain on touch. In the author's clinical assessment, these were related to prolonged preoperative nerve compression. Pregabalin was prescribed, and these symptoms decreased while taking it.
Original source and case context
This describes one clinical case and the actual follow-up of this patient. The result is not a promise of the same course for someone else; treatment is planned individually.
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