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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03-DECEMBER-2009 AYMAN HASAN SALAMEH 31
YEARS EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
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was admitted urgently to Shmaisani hospital 30-November-2009
complaining of LBP with right sciatica for 5
days with agonizing pain depriving him sleep.
The patient was
unable to walk with exaggerated scoliotic stance. SLRS
5 degrees in the right and 60 degrees in the
left. He had weak dorsiflexion right foot 4/4 and
planterflexion 3/5 with hypalgesia right S1 root.
MRI lumbar spine performed
30-November-2009 showing extruded disc L5-S1 with
Right L5-S1 hemiflavotomy with
exposure of the compressed right S1 root.
There was no epidural fat due to severe
compression. Using image-intensifier during all
steps of surgery the level of L5-S1 was confirmed
and the extruded disc was removed lateral to the
axilla of right S1 root. Meticulous cleaning of
the disc space of L5-S1 was achieved from the
PEEK Satellite nucleus
replacement sphere No 11 was inserted and check
in AP and lateral views was done confirming
acceptable position of the device. The sphere
all the time trying to shift to the left, in
spite, that, three attempts to bring it back to
Routine closure of the wound
and smooth postoperative recovery and
improvement of the power of left foot.
Recurrence of disc prolapse
is around 15% in this case because the disc
space is still high and the defect of the
annulus fibrosis is wide.