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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10-JUNE-2008 MUSA HUSSEIN ELEWAT 56 YEARS
RECURRENT PLD L5-S1 WITH LEFT UPWARD MIGRATION AND ELEMENTS OF L4-5 STENOSIS.
The patient came to the
clinic 03-June-2008 with
sciatica for three months more the left. He was
operated 2003 for PLD L5-S1 for the same
On examination: the patient
has weak dorsiflexion both feet 4/5 and planterflexion
right foot 4/5.
MRI lumbar spine performed
05-June-2008 showing very recurrence at
L5-S1 more to the left with upward migration
with elements of segmental stenosis at L4-5.
Laminectomy L5 and partial of
L4 was performed. The compressive elements of
L4-5 were eliminated. Scarolysis of the left S1
root was performed. Considering that the disc
space of L5-S1 was very narrow,
image-intensifier was used to confirm the level
of L5-S1. All the extruded disc with the upward
migrating part were removed.
Smooth postoperative recovery
and normalization of the power of both feet.
The recurrence rate in
this case is around zero, because the
disc space height is very minimal.
Recurrent disc leave scar,
for what dissection must be started from the
Good imagination of the
extrusion must be kept in mind so as not to miss
the extrusion, as in this case. It was necessary
to perform isolated surgical route to remove the
upward migrating piece.
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