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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04-AUGUST-2010 SAADIYEH AHMAD ELYYAN 60 YEARS
LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH EXTRUDED DISC L4-5 MORE TO THE LEFT.
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to the clinic 22-March-2010 complaining of
LBP for 7 years with left sciatica for one
month with numbness of the left L5 and S1
territories. The patient is a known hypertensive
and has gout.
On examination: the
patient was limping with exaggerated scoliotic
stance. SLRS was 90 degrees both sides. There
was weak dorsiflexion both feet 4/5 right and
3/5 left, and
planterflexion left foot 3/5. There was severe
O.A. both knees without pain.
23-March-2010 showing severe lumbar canal
stenosis L3-4 and L4-5 with extruded disc L4-5
more in the left.
laminectomy of L4 and partial of L5
with foraminotomy of L5 roots both
sides. Flavotomy of L3-4 was performed. There is no epidural fat and no
overmobility of the segments. Inspection of the
annulus fibrosis revealed the extrusion in the
left side, which was removed and the disc space
of L4-5 was removed from the left side and
bilateral cleaning of the L4-5 disc space was
Routine closure of
the wound and smooth postoperative recovery.
The power of both
feet dramatically improved.
Lumbar canal stenosis is a
progressive disease and early surgical
intervention in case of progression avoid the
patient unnecessary possible complication.
Extruded disc make the picture more fulminant.
Total decompression must be
performed including the canal and the roots. and
removal of the extrusion must be performed,
because in case of leaving it . it will extruded
more because there is plenty of space to extrude
further after the surgery.
The estimated recurrence rate
in this case is ranking around 7%, because the
disc space height still not shallow.
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 .