Dr. Ali Al-Bayyati and Dr. Munir Elias

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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05-APRIL-2012  SAEED THEEB SALEEM  80 YEARS  LUMBAR CANAL STENOSIS L3-4 AND L4-5 AND OLD FRACTURE D12.
 

Anamnesis

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The patient  came to the clinic 21-March-2012 complaining of LBP without sciatica for 3 years with intermittent course. The last 4 months got intermittent claudication with difficult walking and using crutch the last month.

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On examination, the patient was not limping nor having scoliotic stance. He had hypalgesia both lower limbs below the knees with weak both feet dorsi and planterflexion 3/5. Babinski was positive both sides?

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The patient was sent for MRI of the dorsal and lumbar spine with MRMyelography which were done 26-March-2012 showing severe lumbar canal stenosis L3-4 and L4-5. The patient was claiming that his condition is deteriorating and he had no diabetes mellitus, not arterial hypertension.

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The patient was admitted to other hospital 4 days ago for severe diarrhea due to amebiasis and was treated for that. Upon admission his Hb was 7.6 mg/dL with hypoalbumineamia for what these parameters were corrected with packed cells and FFP.

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Decompressive laminectomy L3,4 and upper half of L5 with bilateral flavotomy L2-3. Foraminotomy L4 and L5 roots both sides. The dura was very thin transparent with no epidural fat all over. Check for CSF leak was performed with Valsalva maneuver. No CSF leak.

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Routine closure of the wound. Smooth postoperative recovery. The power of the feet became normal.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

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Lumbar canal stenosis is a progressive disease, the sooner the surgical intervention, the better the outcome.

 

 

 


Back Up!

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 .

 

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