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-2010 JAMAL HASAN ISSA 53 YEARS
HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION AND SECONDARY CANAL
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to the clinic 01-August-2010 complaining of
LBP for 20 years with left sciatica.
Exacerbation of left sciatica the last 3 months down
to the left L5 territory.
20-July-2010 showing severe lumbar canal
stenosis L4-5 with extruded disc L4-5
with left downward migration.
On examination: the
patient walking bended with exaggerated scoliotic
stance. SLRS was 70 degrees left side with pain There
was weak dorsiflexion left foot -3/5 right 4/5, and
planterflexion left foot -4/5. There was mild
O.A. both knees without pain.
Left L4-5 hemiflavotomy with foraminotomy of
left L5 root. There was no epidural fat in the
compressed parts. The extruded disc was removed
in several pieces. after what the root became
lax. Meticulous cleaning of L4-5 disc space from
the left side lateral to the axilla. Inspection
under the axilla revealed no remnants of the
Routine closure of
the wound and smooth postoperative recovery.
The power of both
feet dramatically improved.
Lumbar canal stenosis is the
result of the huge extrusion and surgical
intervention was aimed to resolve the huge
The expected postoperative
recurrence rate in this case is around 7%
because the disc space still not shallow and the
defect in the annulus fibrosis is wide.
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 .