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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02-MARCH-2009 MUTAZ BASEM AL-TWAL 22 YEARS
HUGE EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
The patient came to the
clinic 23-February-2009 complaining of LBP for
one year with
severe right sciatica and exacerbation of right
sciatica the last month.
MRI lumbar spine performed
01-December-2008 showing extruded disc L5-S1
with right downward migration.
On examination: the patient
is limping with mild scoliotic stance. SLRS was
25 degrees in the right with absent AJ with weak right foot
4/5 in dorsi and planterflexion.
23-February-2009 showing very large extruded
disc L5-S1 more to the right bigger than before.
Foraminotomy of the right S1
root was performed and the sequestrated disc
material was removed in one piece lateral to the
axilla. Inspection of the annulus fibrosis
revealed a very small defect for what using tiny
instruments, the remnants of the extruded disc
were removed. The epidural fat was transferred
to the root to minimize the postoperative
Routine closure of the wound after inspection
for CSF leak, which was negative.
Recurrence in this case must
be below the average, because the defect in the
annulus fibrosis was minimal and the disc space
height is also small.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .