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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
20-MARCH-2011 MARYAM ATIYA ABDALLA 65 YEARS
EXTRUDED DISC L4-5 WITH RIGHT UPWARD MIGRATION.
came to the clinic 15-March-2011 complaining of
agonizing right sciatica for 10 days with
numbness and weak right foot. The patient is a
known diabetic under treatment for 10 years.
spine performed 14-March-2011 showing extruded
disc L4-5 with right upward migration.
examination: the patient is limping with
exaggerated scoliotic stance. SLRS was 90
degrees in both sides without pain. There is
weak dorsiflexion right foot -4/5. The patient
was seen by cardiologist and approved her
condition for G.A.
Right L4-5 partial flavotomy with drilling of
the lamina high to reach the upward extrusion.
The extruded disc was removed in several big
pieces. The epidural fat in this area was
missing due to compression. The extruded disc
was compressing the right L4 root at the upper
corner. It was released. Inspection of the L4-5
annulus fibrosis could not find the defect, from
where the extrusion took place. It was
glistening and not causing any compression, for
what it was decided not to violate it.
closure of the wound. Smooth postoperative
recovery. The power of the right foot
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
SLRS was 90 degrees in both sides,
because the extruded disc was sequestrated and separated
from the disc space, for what no friction had place when
moving the leg up.
It was hard to tell if the extrusion is
from L4-5 or L3-4, but the proximity of the extrusion to
L4-5 disc space and nearly 7-8 mm away from L3-4 could with
certainty conclude that, the extrusion was coming from L4-5
Due to these speculations, and the good
alignment of the annulus fibrosis, it was decided not to
violate the L4-5 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 .