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-MAY-2008 LATIFEH SHAKER JARRAR 73 YEARS
SEVERE LCS L2-3, 3-4 AND L4-5 WITH LEFT L4-5 RECESS SYNDROME DUE TO
GANGLION FROM FACET JOINT.
The patient came to the
clinic 27-April-2008 complaining of LBP with
left sciatica for three years. Exacerbation the
last two months and inability to walk the last 4
days. She was complaining of continuous numbness
The patient is a known
hypertensive for 3
years and she underwent labcholi 20 years ago
and bilateral CT-release 15 years ago and she is
in Xeroxat and Depakine for 12 years.
On examination: the patient
was unable to stand for evaluation of scoliotic
stance or gait assessment. SLRS was 50 degrees in the
right and 40 degrees in the left with pain.
He had weak dorsiflexion both feet -4/5.
MRI performed 28-April-2008
showed severe lumbar canal stenosis L2-3, L3-4
and L4-5 with left lateral recess syndrome at
L4-5 with ganglion compressing the root arising
from the left L4-5 facet joint.
Decompressive laminectomy of
L3-4 and partial of L2 and L5 was done.
Foraminotomy of all roots was achieved in the
area. The left L4-5 facet ganglion was removed
and inspection of the L4-5 annulus fibrosis was
done. The root was hanging free.
Routine closure of the wound
with smooth postoperative recovery.
Considerable improvement of the
power of both feet.
Lumbar canal stenosis is a
progressive disease and surgery must be
performed the sooner the better, if the clinical
manifestations are escalating.
Lumbar canal stenosis is not
a cause for radicular pan, and the cause must be
found and resolve, as in this case the ganglion,
which was compressing the left L5 root.
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