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
The patient has drop left leg for
25 years with progressive picture of urinary problems . He was
diagnosed previously as a case of polio. MRI done 28-July-2005
showing lipoma behind L4-5 with tethered cord. On examination the
patient had flail left foot with weak planter and dorsiflexion right
foot with cauda equina syndrome and anesthesia below left L5
root and right S2 root. The patient had a dimple in the lower back.
Laminectomy of L5 and part of L4 and upper sacrum was done. The dura
was opened and the yellow spinal cord was followed caudad down until
it left the dural territory to end as a tiny band.
Electroconductivity studies ruled out its importance and it was cut
there. This extradural extension was reinserted back intradurally
and the scars limiting the roots downward were dissected to make the
spinal cord mobile and free. Water-tight closure of the dura.