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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28-JUNE-2008 FIKRIEY SUBHI AL-QUDSY 63 YEARS
WIDE BASED EXTRUDED DISC L4-5 MORE TO THE RIGHT.
Anamnesis:
The patient came to the
clinic 22-June-2008 with LBP and
right sciatica for 1 year with progressive
course. The patient has arterial hypertension
for 15 years.
MRI of the lumbar spine done
17-May-2008 showing wide-based extruded disc
L4-5 more to the right with foraminal occlusion.
On examination: the patient
is limping with scoliotic stance and dragging
her right foot. SLRS was 30 degrees in the right
with pain. She had weak dorsi and planterflexion
right foot 3/5, and the left foot dorsiflexion
4/5. She had also OA both knees.
Bilateral foraminotomy of both
L5 roots was performed and wide flavotomy was
done. The disc extrusion was removed from the
right lateral to the axilla, then bilateral
cleaning of the disc space of L4-5 was done. Routine closure of the wound.
Smooth postoperative recovery
and the power of both lower limbs improved.
Comments
The patient had extruded disc
of L4-5 which was not responding to conservative
measures. It was decided to perform bilateral
cleaning of the disc space, taking into
consideration the wide base extrusion.
The estimated recurrence rate
is below average, since the disc space is
shallow and bilateral cleaning was performed.
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Notice: Not all operative activities
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