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-MARCH-2004 AZIZA SULAYMAN SALEM ABDEL-RAHMAN EXTRUDED DISC
L4-5 WITH LEFT DOWNWARD MIGRATION.
The patient came to the
clinic 02-July-2008 complaining of LBP for 6
years with right hip pain. Exacerbation of right
sciatica the last 6 months.
MRI of the lumbar spine
performed 19-June-2008 showed extruded disc
L5-S1 with small, but severe compression of the
right S1 root.
On examination: the patient
is limping with scoliotic stance . SLRS was 80
degrees in the right with pain. There is weak
dorsi and planterflexion right foot 4/5.
The patient was advised to
try conservative treatment, because the
extrusion was not large, but he insisted for
surgery, because the pain during the lest 6
months making his life intolerable.
Right S1 foraminotomy with
partial L5-S1 flavotomy was performed. The
extruded sic was severely compressing the right
S1 root. It was removed in two pieces. The disc
space was cleaned meticulously from the right
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the right foot.
The patient has relatively
small extrusion, but with severe compression
upon the right S1 root. In these
circumstances 2 out of 8 patients undergo
The estimated recurrence in
this case is around the average, because the
disc space height still not shallow, but the
defect in the annulus fibrosis is tiny small.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .