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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22-NOVEMBER-2010 HUSAM MAHMOUD HASAN 36 YEARS
RECURRENT EXTRUDED DISC L5-S1 RIGHT SIDE.
came to the clinic 21-November-2010 complaining
of right sciatica and numbness of right L4 and S1
territories for one month. The patient was operated by me
16-September-2004 for huge PLD L5-S1 left
downward migration. The patient then came
18-January-2009 complaining of bilateral sciatica for
15 days. MRI lumbar spine performed
12-January-2009 showing huge extrusion of L4-5
more to the left. He was operated by me
spine performed 20-November-2010 showing
the extruded disc L5-S1 with right foraminal
examination: The patient is in
pain with exaggerated
scoliotic stance. There is weak dorsi and
planterflexion right foot
4/5 with SLRS 20 degrees with pain in the right, hypalgesia right L5 and S1 territories..
Using image-intensifier, foraminotomy of right
S1 root was performed. The extruded disc was
attacked lateral to the axilla and it was
removed in several pieces, after what the root
became lax. Meticulous cleaning of the disc
space of L5-S1 was achieved from the right.
closure of the wound. Smooth postoperative
recovery and improvement of the power of right
The patient has persistent
recurrent extrusion with dark gray extrusion of L5-S1
level, which will
not resolve over the time. Surgical
decompression is the only solution.
The patient underwent
enzymotherapy, after what his condition further
Usually the recurrence take
place at the same side of previous extrusion,
but this case is rare in that, it took place
from the other side.
The estimated recurrence rate
is still around 7% because the disc space is
not shallow, despite the fact meticulous cleaning was
performed from one side.
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