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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09-AUGUST-2008 MUHAMED FUAD HARB 53 YEARS LCS L4-5
WITH CENTRAL EXTRUDED DISC L4-5 WITH RIGHT L5 ROOT COMPRESSION.
The patient came to the
clinic 07-August-2008 complaining of LBP and
right sciatica for one month with exacerbation
the last 5 days. The patient is
insulin-dependent diabetic for 14 years and
known hypertensive for 7 years. The patient
underwent discectomy for L5-S1 15 years ago.
MRI done 06-August-2008
showed residual after discectomy L5-S1 without
recurrence and LCS L4-5 with huge central disc
L4-5 with compression of the right L5 root.
On examination: the patient
has exaggerated scoliotic stance, limping with
SLRS 40 degrees with pain in the right. There is
weak dorsiflexion both feet -4/5 and mild weak
planterflexion right foot with numbness both
right L5 and S1 territories. He has OA. both
Laminectomy of L4 and the
remnant of L5 was performed. Bilateral
foraminotomy of both L5 roots was performed.
Inspection the right L5 root revealed an
extrusion compressing the root below the disc
space, which was removed subsequently.
Inspection the left L5 root revealed extrusion
of the disc material, for what bilateral
cleaning of the disc space L4-5 was performed.
Routine closure of the wound
and smooth postoperative recovery with
improvement of the power of both feet.
The patient had LCS L4-5 with
evident compression of the right L5 root by
extrusion. During surgery, inspection of the
left L5 root revealed another extrusion for what
bilateral intradiscal cleaning was performed.
The estimated recurrence rate
in this case is around the average, because the
disc space height still not shallow.
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