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-DECEMBER-2008 NAHIDAH IBRAHEEM AL-DAHLAH 75
YEARS LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH LEFT LATERAL RECESS
SYNDROME AT L5 ROOT.
The patient was admitted to
the Shmaisani hospital 03-December-2008 with
clinical history of bilateral sciatica more the
right for 2 months with LBP for more than 3
MRI of the lumbar spine
performed 02-December-2008 showing severe lumbar
canal stenosis at L3-4 and L4-5 with left
lateral recess syndrome at L5 root exit.
On examination: the patient
has drop left foot with weak planterflexion both
feet 4/5 and dorsiflexion right foot 4/5. There
is diabetic foot with neuropathic hypalgesia
upon what, the left L5 territory had analgesia.
The drop foot is for more than 2 months.
Decompressive laminectomy of
L3-4 and partial of L5 was performed. The
epidural fat was missing at all levels.
Foraminotomy of both L4 and L5 roots was
performed. The left L5 root was exposed 10 mm
below the point of compression and it was
inspected and the small bony extrusion at this
level from the L4-5 annulus fibrosis was
inspected and it was decided not to violate the
disc space. Routine closure of the wound.
Smooth postoperative recovery
and the power of the right foot normalized and
the planterflexion of the left foot. The
dorsiflexion of the left foot remained the same.
Recovery of the compressed
root depends upon 2 major factors: 1. the degree
of compression with the subsequent damage of the
fibers before surgery, 2. the length of time of
damage, before surgery.
Lumbar canal stenosis is a
progressive disease and the sooner the better to
perform surgery before permanent dame take place
to the compressed root.
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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 .