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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
06-AUGUST-2008 ABDALLAH KAMAL AL-QAWASMEH 45 YEARS
HUGE CENTRAL DISC L4-5 WITH LEFT OLD AND FRESH RIGHT EXTRUSION.
The patient came to the
clinic 29-July-2008 complaining of LBP and right
sciatica for 20 days. The patient had left
sciatica 5 years ago.
MRI done 13-July-2008 showed
huge central extrusion of L4-5 with old left and
fresh right sided extrusion with compression of
both L5 roots.
On examination: the patient
has exaggerated scoliotic stance, limping with
SLRS 20 degrees with pain in the right. There is
weak dorsiflexion right foot 4/5.
Bilateral L5 foraminotomy
with bilateral flavotomy was performed. The soft
right extrusion was attacked first lateral to
the axilla and meticulous cleaning of the disc
space of L4-5 was performed.
The bony hard extrusion was
attacked lateral to the left L5 root and it was
removed and meticulous cleaning was performed
from the left.
Considering that bilateral
cleaning was performed and the defect of the
annulus fibrosis was considerably large, it was
intentionally decided to widen the defect
lateral to the right axilla in the annulus
fibrosis, so as to minimize pain in case of
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the right foot.
The estimated recurrence rate
in this case is around the average, because the
disc space height is still not shallow.
In case of bilateral
cleaning, the defect in the annulus fibrosis is
relatively wide. In such a case, it is
preferable to extend the defect more far
lateral, so as to ease the pain in case of
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
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 .