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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21-NOVEMBER-2012 ABDEL-AZIM ABDEL-HAMID MUHAMED 42
YEARS EXTRUDED DISC L3-4 WITH SECONDARY STENOSIS.
Anamnesis
The patient came to the clinic 05-May-2007
complaining of neck and right shoulder pain for
4 years with weak extension of the right hand
4/5 and hypalgesia middle finger right hand. MRI
performed at that time showed small extrusion
C5-6 and was treated conservatively.
The patient then came 06-June-2012 complaining
of LBP and right sciatica for one month with
bilateral sciatica when walking. The patient has
arterial hypertension for 2 years.
MRI of the lumbar spine done 23-October-2012
showing extruded disc L3-4 more to the right.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS 75 degrees
both sides
with pain. There is
weak dorsiflexion left foot 3/5 and right
foot 4/5.
Using image-intensifier,
Bilateral flavotomy L3-4 was done with
foraminotomy both L4 roots. The extruded disc
was removed from the right first, then bilateral
removal of the extrusion and cleaning of L3-4
disc space was achieved.
Routine closure of the wounds. Smooth
postoperative recovery. The power of both feet
became normal.
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Comments
The patient still has an
estimated postoperative recurrence around 7%,
because the disc space is still not shallow.
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