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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14-JUNE-2008 MUNIRA ABDEL-RAHMAN KHADER RECURRENT
PLD L4-5 WITH RIGHT FAR-LATERAL EXTRUSION AND SEGMENTAL LCS L4-5.
Anamnesis:
The patient came to the
clinic 12-June-2008 with
LBP and right sciatica, which continued after
surgery which was performed in USA seven years
ago, for PLD L4-5 and right sciatica.
On examination: the patient
has scoliotic stance using crutches with weak
dorsiflexion right foot 3/5 and left foot 4/5
and weak planterflexion right foot 4/5.
MRI lumbar spine performed
recently showing huge recurrent PLD L4-5 with
right far-lateral extrusion and segmental lumbar
canal stenosis L4-5.
Removal of
the remnant of L4 was performed and partial of
L3 lamina. Foraminotomy of
right L5 root was achieved. The right far-lateral
extrusion and the centrally locating extrusion was removed and meticulous cleaning of
L4-5 was performed from the right.
Image-intensifier was used to speed the
operative management.
Smooth postoperative recovery
and the power of feet improved dramatically.
Comments
The recurrence rate in
this case is below the average, because the
disc space height is minimal.
Recurrent disc leave scar,
for what dissection must be started from the
healthy tissues.
Good imagination of the
extrusion must be kept in mind so as not to miss
the extrusion.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
connection.
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 .
