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
22-JUNE-2006 AZZAM SHAWQY KHALEEL 43 YEARS
HUGE L5-S1 RIGHT SIDED EXTRUSION WITH DOWNWARD MIGRATION.
The patient came came to the clinic 11-June-2006 complaining of
right sciatica for 4 months. MRI done 27-March-2006 showing
extruded disc L5-S1 with right downward migration. He claims that,
he had partial improvement, but still complaining of dyseasthesia of
the right S1 territory.
On examination, the patient was limping
and scoliotic stance with SLRS right 80 and left side 75 degrees
with pain. He had weak dorsiflexion both feet and planterflexion
right foot. The patient was sent for another MRI, which showed a
very huge extrusion of the same disc and he was advised to undergo
surgery. The patient was admitted by other doctor and traction with
several pain-killer cocktails were tried without effect.
Right L5-S1 hemiflavotomy was performed with foraminotomy of the
right S1 root. The huge extrusion was removed in one piece lateral
to the axilla. Small remnant was removed from under the axilla and
partial cleaning of the disc space was performed from the right
through the same defect of the annulus fibrosis, through which the
extrusion took place.