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-MAY-2008 KHALDIYEH IBRAHEEM AL-FAR 65 YEARS
LUMBAR CANAL STENOSIS L3-4, L4-5 WITH RIGHT L4-5 LATERAL RECESS SYNDROME.
The patient came to the
clinic 07-January-2004 complaining of LBP with
left sciatica for one month. She could walk more
than 1 Km
with SLRS 90 degrees with weak dorsiflexion all
toes both feet.
MRI lumbar spine performed
22-December-2003 showed lumbar canal stenosis at
L4-5 with left lateral recess syndrome. The patient
is a known hypertensive and diabetic and she was
The patient then came 10-May-2008
with agonizing low back pain and right sciatica for
6 days after dancing during the ceremony of her son
SLRS with pain in the right
80 degrees and 90 degrees in the left. She had weak dorsiflexion right foot 4/5.
MRI performed 12-May-2008
showed severe lumbar canal stenosis at L3-4
and L4-5 with bilateral recess syndrome with
spondylolisthesis of L4-5 first degree by
Meyrding. There was an extruded ganglion from
the right L4-5 facet.
Decompressive laminectomy of
L4 and partial of L3 and L5 was performed.
Foraminotomy of both L5 roots was achieved. The
ganglion was removed. It was possible to notice
the linear fracture at the isthmus of right L4-5
Routine closure of the wound
with smooth postoperative recovery.
Considerable improvement of
the power of the right foot.
The patient has many surgical
findings: stenosis, spondylolisthesis, acute
fracture of the right isthmus and old ganglion
from the right L4-5 facet.
The surgical treatment protocol
must take into consideration all these elements and
perform the optimal resolution of the problems.
The annulus fibrosis was
acceptable, for what the disc structure was not
violated, to prevent possible further increase of
All the stenotic elements were
eliminated to avoid further escalation of the
stenosis in the scoped future.
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