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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27-MAY-2008 MUHAMED SALEH SHALAAB 32 YEARS
EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
The patient came to the
clinic 24-May-2008 complaining of LBP with left
sciatica for 5 years. Exacerbation of sciatica
the last 50 days with limping and difficult
walking and positive cough sign.
MRI lumbar spine performed
14-April-2008 showed extruded disc L5-S1 with
left downward migration.
On examination: the patient
in agonizing pain with exaggerated scoliotic
stance. SLRS was 65 degrees in the left with
pain. There was weak dorsiflexion both feet more
the left with weak planterflexion left foot 4/5.
Left L5-S1 hemiflavotomy with
foraminotomy of left S1 root was performed. The
extruded disc was removed lateral to the axilla.
Meticulous cleaning of the disc space from the
left side. Inspection under the axilla and the
foramen for remnants.
The epidural fat was kept
untouched through the operation.
Routine closure of the wound
with prompt recovery of the power of both feet.
The recurrence rate is around
7% in this case, because despite the meticulous
unilateral cleaning, the disc space was still
high and the defect in the annulus fibrosis was
Preserving the epidural fat
minimize the incidence of postoperative
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .