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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07-MARCH-2010 YOUSEF SAYYED AL-JOLASY 45 YEARS
RECURRENT EXTRUSION L5-S1 LEFT SIDE WITH LEFT LATERAL RECESS SYNDROME L4-5.
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patient came to the clinic 23-August-2008
complaining of right sciatica for 2 years. The
patient was operated for left sciatica 7 years
ago and discectomy of L5-S1 was done at that
MRI lumbar spine
done 24-August-2008 showing small extrusion of
L5-S1 right side and fibrosis in the left side.
He was advised to keep in conservative
The patient the last
came 24-February-2010 complaining of left
sciatica for 4 months with MRI of the lumbar
spine the same day showing lateral recess
left side with the extruded old extrusion L5-S1
The patient is
limping when in pain with exaggerated scoliotic
stance and weak dorsiflexion left foot -4/5.
Left L5 root foraminotomy
with left L4-5 hemiflavotomy was performed.
Inspection of the left S1 root, showed extruded
disc L5-S1 with severe compression of the root. The
extruded disc was removed under the axilla
and left sided cleaning of the disc space was
achieved. The extrusion was rubbery hard and
adherent with root and it was separated with
great care to avoid traumatic injury to the left
Routine closure of the wound.
recovery, and the power of left foot normalized.
MRI still not informative to
tell exactly what is going on. The MRI was 1.5
tesla and Siemens with good quality. Despite
that, it is possible to get misinterpretation
about the morphologic data and the real
answer would be during surgery. In the near
future we will use 3 tesla Verio Siemens
and see if these misinterpretations could be
In case you are suspecting
two causes of the problem, check for them both,
so as to avoid wrong plan of surgery.
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 .