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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The patient came to the
clinic 01-September-2009 complaining of right
sciatica for the last 20 days. The patient was
operated by me
14-June-2005 for huge PLD L4-5 and
came to me 09-January-2008 with right sciatica
and was sent for MRI of the lumbar spine, which
was done the same day, showing extruded disc
L3-4 and was advised to undergo surgery, but the
patient escaped. He did not perform surgery and
improved over several months.
MRI lumbar spine performed
29-August-2009 showing huge recurrence of L4-5
with downward migration and disappearance of the
extruded disc at L3-4.
On examination: the patient
is limping with exaggerated scoliotic stance.
SLRS was 80 degrees in the right with pain with
complete drop right foot and analgesia of right
L5 root and hypalgesia of right S1 root.
Right L5 foraminotomy with
the use of imageintensifier and the extruded
disc was removed lateral to the axilla in one
piece. Considering that the disc space of L4-5
is completely collapsed, it was intentionally
Routine closure of the
wound and smooth
and the patient sent to
The patient has complete
collapse of the L4-5 disc space, for what the
expected recurrence rate in this level would be
PEEK satellite sphere cannot
be used in this case, because it is simply not
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 .