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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16-JANUARY-2010 RAIDA LUTFI AWWAD 39 YEARS EXTRUDED DISC L4-5
CENTRAL MORE TO THE RIGHT.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient came to the
clinic 12-January-2010 complaining of low back pain
for 6 years with bilateral sciatica more the
right . The last 3 months progressed right
sciatica down to L5 territory, making her
unable to walk more than 50 meters. She had
exaggerated scoliotic stance with SLRS 5 degrees
in the right. There was weak dorsiflexion 3/5 of
the right foot.
12-December-2009 showing extruded disc L4-5 huge
central more to the right.
image-intensifier the L4-5 level was identified
and right hemiflavotomy L4-5 with foraminotomy
of right L5 root was performed. The extruded
disc was removed lateral to the axilla and right
sided cleaning of L4-5 was done from the right.
Satellite spinal system, it was necessary to use
sphere No 15 to have acceptable prerequisites
and check image-intensifier showed central
location of the device. The curette was
not used intentionally, so as not to harm the
endplate. Contrast was injected inside the disc
space from the right. It was noted that the
contrast media could not cross the right half to
Routine closure of the wound.
recovery, with improvement of the power the
The surgeon think
that he performed meticulous cleaning of the
disc space. The use of contrast in this case was
an illustration, that the disc remnants still
there. Even the contrast could not fill the gap
contra-lateral the excision and cleaning. This
means, that there is still layers of the disc
material behind the sphere.
The diameter of
the sphere is an indicator to the possible
postoperative estimated recurrence . The more
the diameter is parallel with the higher
recurrence , in case of not using the sphere.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .