Surgical group is like a football team.

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  neurosurgery.tv

The patient came to the clinic 20-June-2006 complaining of LBP for 20 years. Exacerbation of right sciatica the last 5 months down to L5 territory with numbness of the big toe right foot. The patient cannot walk more than 50 meters. LSS X-ray showing severe degenerative spine with advanced structural scoliosis.

On examination: SLRS was 50 degrees in the right. Weak dorsiflexion left foot with mild OA both knees. MRI of the lumbar spine performed 26-June-2006 showing severe LCS L3-4 and L4-5. The patient is a known hypertensive with diabetes mellitus, for what cardio consultation was asked and the patient was operated.

Decompressive laminectomy L3-4 was done and despite the fact that in the MRI, the compression was more evident in the left side, but during surgery the compression was more pronounced in the right at the level of L3-4 with black color of the ligamentum flavum at that level, which could be heamosederin deposition after possible trauma or degenerated old ganglion cyst arising from the right L3-4 facet.. All the compressive elements were treated and foraminotomy of both L4 and 5 roots was achieved.

Prompt postoperative recovery with improvement of motor power of the left foot and resolution of shooting right sciatica.


1. MRI of the spine even in 3 tesla is not all the time showing all the details. For technical reasons, some elements could be missed and can be found in the operating table. This fact enforce the idea, that small hole surgeries has no place in the disc  in particular and degenerative spine in general pathologies.

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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved