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Munir Elias 20-12-2013
Surgical group is like a football team.

 
Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.tv

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03-OCTOBER-2008  AHMAD ODEH AL-LAWI 75 YEARS  DE NOVO POSTTRAUMATIC HUGE EXTRUDED DISC L2-3 MORE TO THE RIGHT . CONDITION AFTER DECOMPRESSIVE LAMINECTOMY  FOR LCS L3-4, L4-5 2 MONTHS AGO.

Anamnesis:

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The patient came to the emergency of Al-Shmaisani hospital 03-October-2008 complaining of bilateral sciatica with inability to walk for 8 days.

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The patient was operated by me 21-August-2008 for LCS L3-4 and L4-5.

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MRI performed today showing a huge de novo extruded disc L2-3 more to the right.

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On examination: the patient in agonizing pain and has weak both quadriceps muscles 4/5 and weak dorsiflexion both feet 3/4 and abduction of the knees 4/5. SLRS was 90 degrees both sides.

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During dissection of the spinous process, it came obvious, that there is fracture of the spinous process and the right medial part of the L2-3 facet, which were subsequently removed.

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The right L3 root was identified and the huge extruded disc L2-3 was removed intentionally in several pieces, so as to prevent dural damage.

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Meticulous cleaning of disc space of L2-3 was performed from the right.

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Routine closure of the wound. The power of both legs improved more in the right side.

Comments

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The patient underwent decompressive laminectomy of L3-4 and partially of L2 and L5 2 months ago.

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The patient and the family were interrogated after surgery and they told us that the patient felt twice, after what he got this complication.

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There is no connection between the two events, and by no means the second surgery has relation with first.

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The estimated recurrence in this case is below average, because the disc height is shallow.

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