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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17-DECEMBER-2011 NAJEEB HALEEM HADDAD 52 YEARS
GANGLION LEFT L5-S1 FACET WITH FORAMINAL OCCLUSION AND MILD DEGREE OF
patient came to the clinic 29-October-2011
complaining of LBP for 6 months, left sciatica
for 3 months with exacerbation of LBP and left
sciatica the last 2 months. MRI done
20-October-2011 showing mild spondylolisthesis
L5-S1 with mild extrusion left side. There was
mild weak dorsiflexion left foot 4/5 with mild
scoliosis. The patient was advised to keep in
patient then came 13-December-2011 claiming that
he was doing well until the last 2 days, he
progressed agonizing left sciatica .
examination, the patient was limping and with
inverted scoliotic stance. There is weak
dorsiflexion left foot 3/5.
patient was sent for new MRI of the lumbar spine
which was done 14-December-2011 showing
considerable extrusion of the disc of L5-S1 with
complete left foraminal occlusion. There is mild
spondylolisthesis L5-S1, which of no clinical
significance. The MRI report was that the lesion
was ganglion originating from the left L5-S1
Left S1 foraminotomy was
performed. There is glistening mass compressing
the left S1 root medial and posterior. Drilling
of the lateral mass was achieved, so as to see
the origin of the extruded mass, which proved to
be a ganglion from the left lateral mass. It was
removed and inspection of the annulus fibrosis
of L5-S1 disc space was without any extrusion.
closure of the wound. Smooth postoperative
recovery with improvement of the power of
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The patient has mild degree of spondylolisthesis
which is clinically of no significance. The de
novo extrusion was the triggering factor for
pain generation and further weak left foot.
The mass if a ganglion or an extrusion must be
surgically resected, because it was hard in
consistency and severely compressing the root.
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 .