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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15-DECEMBER-2008 ABDEL-FATTAH HAMED AL-LIDDAWI 65
YEARS LUMBAR CANAL STENOSIS L4-5.
The patient came to the
clinic 16-October-2008 complaining of LBP with
bilateral sciatica for 10 years with
exacerbation the last 2 years. He has
intermittent claudication and can walk less than
On examination: the patient
has weak dorsiflexion both feet 4/5. He has
scoliotic stance with SLRS 70 degrees both sides
The patient is a known
diabetic for 19 years under treatment.
MRI of the lumbar spine with
MRMyelography was performed 16-October-2008
showing lumbar canal stenosis L4-5 and lesser
degree at L3-4.
Decompressive laminectomy of
L4 and partial of L3 and L5 was performed. The
epidural fat was missing at all levels.
Foraminotomy of L5 roots was
performed both sides. Inspection of the L4-5 annulus fibrosis was
negative and it was decided not to violate the
disc space. Routine closure of the wound.
Smooth postoperative recovery
and the power of both feet normalized.
Recovery of the compressed
root depends upon 2 major factors: 1. the degree
of compression with the subsequent damage of the
fibers before surgery, 2. the length of time of
damage, before surgery.
Lumbar canal stenosis is a
progressive disease and the sooner the better to
perform surgery before permanent dame take place
to the compressed root.
So as to prevent estimated
progression of the stenosis at L3-4 in the near
future, it was decided to decompress it as well.
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