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
neurosurgery.tv
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20-MARCH-2012
KHALIDA MUHAMED AL-HAYMOUNI 45 YEARS HUGE EXTRUDED DISC L4-5 WITH
RIGHT DOWNWARD MIGRATION.
Anamnesis
The
patient came to the clinic 19-March-2012
complaining of LBP for 8 years with right
sciatica for 2 months down to all toes right
foot more to the big toe with difficult walking
and positive cough sign.
MRI lumbar spine performed 04-March-2012 showing
huge extruded disc L4-5 with right downward
migration.
On
examination, the patient is limping with severe
exaggerated scoliotic
stance. SLRS was 70 degrees in the right with
pain. She has weak dorsi and planterflexion
right foot 3/5. There is hypalgesia right L5
root territory.
Right
L5 foraminotomy with partial flavotomy L4-5. The
extruded disc L4-5 was removed lateral to the
axilla. Cleaning of the L4-5 disc space was
achieved from the right side. The root now is
hanging free but epidural fat. The surrounding
fat was transferred to this area to decrease the
postoperative fibrosis.
Routine
closure of the wound. Smooth postoperative
recovery. The power of the right foot became
better.
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Comments
The patient still having
an estimated postoperative recurrence around 7%,
because the disc space height still not shallow.
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 .
