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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18-NOVEMBER-2008 ABDALLAH MUHAMED HASAN AL-HORANY
57 YEARS LUMBAR CANAL STENOSIS L3-4 AND L4-5.
Anamnesis:
The patient came to the
clinic 15-November-2008 complaining of LBP for 3
months with bilateral sciatica with intermittent
claudication.
MRI lumbar spine performed
09-November-2008 showed lumbar canal stenosis
L3-4 and L4-5.
On examination: the patient
has mild scoliotic stance,
with weak planterflexion both feet 4/5 and
dorsiflexion 4/5 with hypalgesia right L5 and S1
territories.
Skeletonization of L3 down to L5
laminae revealed superficial fracture of the
posterior wall of the left L4-5 facet without
causing instability.
Laminectomy of L3 and 4 was performed the upper edge
of L5 with bilateral foraminotomy of L4 and L5
roots. Inspection of the annulus fibrosis of
L3-4 and L4-5 ruled out the presence of
extrusion. The dura was lacking epidural fat at
many places due to the previous compression.
Routine closure of the wound.
Smooth recovery with prompt
improvement of the power of both feet.
Comments
The patient has short
anamnesis for LCS, which could be explained by
inflammatory process of the already
hypertrophied ligamentum flavum at these levels.
The presence of chip fracture
of left L4-5 facet could also explain some sort
of trauma which provoked the hidden process.
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