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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19-JUNE-2010 LINDA SABRI TAIEM 31 YEARS HUGE
EXTRUDED DISC L5-S1 LEFT SIDE.
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to the clinic 25-August-2009 complaining of LBP
for three years with left sciatica for one month with
numbness of the second and third toe left foot.
The patient at that time, had SLRS 70 degrees in
the left with exaggerated scoliotic stance with
weak dorsiflexion 3/5 and planterflexion 4/5 of
the left foot and hypalgesia below the left
knee. MRI done 31-December-2007 showed extruded
disc L5-S1 left side.
The patient was
sent to new MRI, which was done
08-September-2009 showing increase of the
The patient then
came 17-June-2010 with new MRI performed
17-June-2010 showing very huge extrusion of the
disc with agonizing pain urging for surgery. The
patient is unable to walk or set of sleep
supine. She has exaggerated scoliotic stance
with drop left foot1/5 dorsiflexion and weak
planterflexion both feet 4/5.
Using image-intensifier (The patient has
lumbarization of the sacrum), a 3-cm incision
was done and foraminotomy of the left S1 root
The extruded fragments were removed lateral to
the axilla after what the root became lax and
free. Further cleaning of the disc space was
done from the left side.
Routine closure of the wound and smooth postoperative recovery with
improvement of the power of the left foot.
The patient had an extrusion
that all the time is increasing in size. The
patient was reluctant for surgery, but when the
pain made her unable to live, she came urging
The estimated recurrence rate
in this case is below 7%, because the disc space
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 .