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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14-AUGUST-2010 SAMYA MUSTAFA AL-JUNAYDY 78 YEARS
SEVERE LUMBAR CANAL STENOSIS L3-4, L4-5 WITH EXTRUDED DISC L3-4 LEFT SIDE.
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admitted to Shmaisani hospital 10 days ago with
clinical history of constipation and LBP and
left sciatica and inability to walk and
difficulty to set due to severe agonizing pain
for one week. The patient had old fracture L1 15
years ago and osteoporosis. The patient was seen
by me 3 days ago with LBP and left agonizing
sciatica and weak dorsiflexion and
planterflexion left foot 3/5.
MRI lumbar spine
performed 09-August-2010 showing severe lumbar
canal stenosis at L3-4, L4-5 with extruded disc
L3-4 left side.
On examination: the
patient is bedridden and has basal crepitation
of both lungs, for what respiratory therapy was
started. The patient was in Clexane 20 mg which
Decompressive laminectomy of L3 and L4 and
partial of L5 with
flavotomy of L2-3 was performed. Foraminotomy of
both L4 roots was achieved. The dura was thin
transparent, that the roots were seen through
it. There was no epidural fat along the
whole territory of decompression. The extruded
disc of L3-4 was removed from the left side,
after what the left L4 root regained relaxed
position. The disc space was shallow and it was
necessary to make small drilling to remove the
intradiscal material, which was minimal. There was no
signs of overmobility. Routine closure of the
Smooth postoperative recovery and improvement of
the power of left foot.
Lumbar canal stenosis is a
progressive disease and decompression must
include the recent clinically manifesting
themselves and the progressing nearby. For
that reason, decompression was achieved at L2-3,
and L4-5 levels.
The extruded disc was of
small size, but considering that the canal was a
stenotic one severe compression was noted.
Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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