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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
01-DECEMBER-2011 MURAD ADNAN TULUSTAN 40 YEARS
EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
patient came to the clinic 29-November-2011
complaining of LBP for 1 month with left
sciatica after one week with numbness big toe
spine performed 27-November-2011 showed extruded
disc L4-5 with left downward migration with
foraminal occlusion with bulge of the L5-S1 more
to the right.
examination, he could walk without limping, nor
scoliotic stance, but SLRS was 45 degrees in the
left with pain with weak dorsiflexion left foot
2/5 and analgesia left L5 root and hypalgesia
left S1 root territories.
Using C-arm the L4-5 level was identified and
left L5 foraminotomy with partial flavotomy was
done. The root was severely compressed and there
was huge veins covering the area after exposure.
They were coagulated to make it possible to
proceed. The extruded fragment was hard and it
was removed by piece-meal fashion. The disc
space of L4-5 was cleaned from the left side and
osteophytectomy was achieved by drilling. The
root became relax and free of any compression.
recovery with improvement of the power of
the left foot.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient had up and downward migrating disc compression of the
root with hard disc, causing agonizing sciatica.
If the piece was soft, no need for surgery, but
the piece is hard in consistency and it will not
shrink with time.
The estimated postoperative recurrence is still
around 7%, because the disc space is not shallow
and the calcified annulus fibrosis which was
part of the extrusion was removed.
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 .