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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25-NOVEMBER-2013 ABDEL-JABBAR YOUNIS ABU-SHKHEYDEM
45 YEARS EXTRUDED DISC L3-4 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient came to the clinic 24-November-2013
complaining of LBP for 20 years with
intermittent course. Right
sciatica for 5 days with difficult walking and
standing and numbness right leg below the knee.
MRI lumbar spine done 19-November-2013 showing
extruded disc L3-4 with right foraminal
occlusion. There is also bulge L2-3, L4-5 and
first degree spondylolisthesis L5-S1.
On examination is limping with exaggerated
scoliotic stance. SLRS was 70
degrees right side with pain. The right KJ
is absent. There is weak
dorsiflexion right foot -4/5 and also the right
quadriceps muscle -3/5. Sensation was intact,
but there is dyseasthesia below the right knee.
Using C-arm, the L3-4 level
was identified and foraminotomy right L4 root
was performed. The extruded disc was removed
lateral to the axilla and right sided cleaning
of L3-4 disc space was achieved. Routine closure
of the wound.
Smooth postoperative
recovery. The power of the right leg became
normal.
Comments
The patient still has an estimated postoperative
recurrence around 7%, because the disc space is
still not shallow.
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