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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11-APRIL-2010 MUHAMED NOOR LUTFI AL-ATTAR
65 YEARS LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH BILATERAL
EXTRUSION OF L4-5.
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to the clinic 07-November-2007 complaining of
LBP for 2 months with right sciatica. MRI
done 03-Nevember-2007 showing lumbar canal
stenosis L4-5 with right far lateral extrusion
and wide based extrusion of L3-4. The patient is
a known diabetic insulin-dependent. There was
weak dorsiflexion right foot 4/5. The patient
was advised to undergo conservative treatment
and he improved.
The patient then
came 28-March-2010 complaining of LBP with
bilateral sciatica more the left for more than 1
year, reaching the ankles. The patient could
walk more than 1 Km .
performed 12-March-2010 showing severe lumbar
canal stenosis L3-4 and L4-5 with bilateral recess
On examination: the
patient has weak dorsiflexion left foot
3/5 and right foot 4/5. The patient now is under
Caduet for 2 years for arterial hypertension.
Decompressive laminectomy L4 and
partial of L3 and L5 was performed and the annulus
fibrosis of L4-5 was checked for fresh extrusion. It
was negative both sides. Foraminotomy of the right
L5 root was performed easily, but it was necessary
to extend it for 17 mm along the left L5 root to
achieve acceptable release. Using the pedicle
protocol of ISIS Inomed , study of both roots was
performed. The right root was responding to 0.02 mA,
but the left was responding to 0.35 mA.
Routine closure of the wound.
full recovery of the
power of both feet.
Lumbar canal stenosis is a
progressive disease and the sooner the better
Considering that the left L5
root was badly compressed, studying it with its
counterpart, showed mild difference between the
2 nerves. But the functional status of the nerve
was acceptable after decompression, for what
prompt postoperative recovery was anticipated.
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 .