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
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01-MARCH-2008 FARAJ FARIS ABU-NIJMEH 53 YEARS HUGE EXTRUDED DISC
L5-S1 LEFT SIDE.
The patient came to the
clinic 24-February-2008 complaining of LBP for 1
month with exacerbation the last week with left
sciatica and positive cough sign.
On examination: the patient
is limping and has scoliotic stance. SLRS was 85
degrees in the right and 70 degrees in the left
with radiating pain to the left leg. The
patient had weak dorsiflexion left foot
The patient was sent for MRI
lumbar spine which was done 27-February-2008
showing huge PLD L5-S1 left side.
Foraminotomy of left S1 root
was performed and partial flavotomy of L5-S1 was
done. The extruded disc was removed lateral to
the axilla in three successive pieces.
Inspection of the disc space, confirmed that the
disc space was practically obliterated, for what
it was decided not to violate it.
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the left foot.
Foraminotomy of the involved
root must be done in all disc surgeries to be
sure that there is no remnant left under the
The disc space was very
shallow, for what the expected recurrence rate
in this case is almost zero.