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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08-OCTOBER-2008 FAREED MUHAMED ALIA 40 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
emergency of Al-Shmaisani hospital
07-October-2008 complaining of agonizing right
sciatica for 2 weeks, depriving him sleep.
MRI of lumbar spine performed
today showing extruded disc L5-S1 with right
downward migration.
On examination: the patient
had weak planterflexion right foot 3/5 and
dorsiflexion right foot 4/5 with anesthesia of
S1 and hypalgesia of L5 root territories. SLRS
was 30 degrees in the right with pain.
Right S1 root foraminotomy
and right L5-S1 hemiflavotomy was performed. The
right S1 root was pushed laterally and the
extruded disc was removed from under the axilla.
After removal of the extrusion, the root was
shifted medially and right sided cleaning of
disc space was performed meticulously. The
epidural fat was preserved and turned back to
cover the root.
Routine closure of the wound.
The power of the right foot normalized
immediately after surgery.
Comments
The patient has short period
of suffering, for what prompt recovery was noted
after surgery.
The expected recurrence rate
in this case is slightly below 7%, because the
disc space height is less than normal.
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Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
