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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12-NOVEMBER-2009 HUSSEIN ALI AHMAD AL-DARDM 40
YEARS LUMBAR CANAL STENOSIS L3-4, L4-5 WITH EXTRUDED DISC L3-4 LEFT SIDE.
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came to the clinic 10-November-2009 from
complaining of LBP with bilateral sciatica for 2
years with exacerbation of left sciatica the
has squint left eye since childhood. He was
limping with exaggerated scoliotic stance. He
had parahypalgesia below D9 both sides with SLRS
40 degrees in the right and 70 degrees in the
left. He had weak dorsiflexion both feet 4/5
right and 3/4 left side and planterflexion left
foot 4/5. Both quadriceps femori power 4/5.
dorsal spine performed
10-November-2009 showing old deformity of the
upper dorsal spine with malacia of the spinal
cord at the d6-7 level. MRI lumbar spine showing
severe lumbar canal stenosis L3-4 and L4-5 with
extruded disc L3-4 more to the left.
Skeletonization of L3 and L4
laminae was performed and laminectomy of L4 and
partial of L3 was done. There is no
epidural fat due to severe compression. Using
image-intensifier during all steps of surgery
the level of L3-4 was confirmed and the extruded
disc was removed lateral to the axilla of left
L4 root. Meticulous cleaning of the disc space
of L3-4 was achieved from the left.
PEEK Satellite nucleus
replacement sphere No 13 was inserted and check
in AP and lateral views was done confirming
acceptable position of the device.
Routine closure of the wound
and smooth postoperative recovery and
improvement of the power of both feet.
Recurrence of disc prolapse
is around 15% in this case because the disc
space is still high and the defect of the
annulus fibrosis is wide.
To minimize this to 2% PEEK
Satellite nucleus replacement sphere was
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 .