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-SEPTEMBER-2008 ADNAN MUHAMED EED AL-HALAQ 54
YEARS HUGE EXTRUDED DISC L4-5 WITH MASSIVE LEFT DOWNWARD MIGRATION.
The patient came to the
clinic 17-September-2008 complaining of LBP with
right sciatica for four years. The last three
weeks got exacerbation of the LBP and left
sciatica with numbness all toes both feet.
11-September-2008 showed very huge extrusion of
L4-5 disc with old right extrusion in the upper
corner and left downward migration.
The patient was treated
elsewhere by traction for 5 days without
On examination: the patient
in agonizing pain with scoliotic stance and
signs of urine dripping. The patient was limping
dragging his left foot. SLRS was 80 degrees with
pain with bilateral hypalgesia both L5 and S1
territories. He had almost drop left foot and
weak dorsiflexion right foot 4/5. Planterflexion
both feet 4/5.
Bilateral flavotomy of L4-5
was done and foraminotomy of left L5 root was
achieved. Two very huge extruded disc
material was removed from under the left axilla.
Bilateral cleaning of the disc space was
performed starting from the right side, then the
left side. Meticulous cleaning was performed.
The roots became lax.
Routine closure of the wound
and smooth postoperative recovery.
The patient had very huge
extrusion. Traction by no way will help, in the
contrary, it will provoke damage to the neural
The estimated recurrence in
this case is below the average <7%, because the
disc height is less than average.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
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 .