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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08-FEBRUARY-2014 ABDELRAHEEM BASHEER SUWASEE 22
YEARS EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
The patient came to the clinic 05-February-2014
complaining of LBP and right sciatica for 1 year with
exacerbation last 4 months. MRI lumbar spine
done 25-December-2013 in Libya bad quality, but
showing the extruded disc L4-5 with right
downward migration. MRI repeated
03-February-2014 showing the same extrusion.
On examination; the patient is limping with
exaggerated scoliotic stance
with agonizing LBP. SLRS was 20 degrees with
pain right side. Weak dorsiflexion right foot
3/5 and planterflexion same foot 4/5.
Using C-arm the level of L4-5 was identified.
Using EasyGo system, not complete set, a 23 mm
tube was inserted. It was not anatomic, for what
a bulk of muscle slipped to the field. This was
managed somehow. The tube was long, that
drilling was impossible, for what the system was
stopped. With the same incision, foraminotomy of
the right L5 root was done and the extruded disc
was removed lateral to the axilla. Right sided
intradiscal cleaning L4-5 disc was done.
recovery. The power of the right foot became
The patient still have an estimated
postoperative recurrence around 7% because the
disc space is not shallow.
EasyGo system is an attractive one, but the
tubular system must have several lengths with
anatomic configurations, to make it running in
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