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-APRIL-2013 ADEL AHMAD MUSSAED 38
YEARS RECURRENT PLD L5-S1 WITH LEFT DOWNWARD MIGRATION AND
RIGHT SCIATICA.
Anamnesis
The patient came
to the clinic 04-April-2013 with LBP
and bilateral sciatica more to the right the last
4 months down to the lateral aspect of the right
ankle. The patient was operated in Egypt 2008
for bilateral sciatica more to the left. The
patient is diabetic insulin dependent for 8
years.
MRI lumbar spine done 28-March-2013 showing extruded recurrent disc L5-S1 with left downward
migration. Dynamic studies were normal.
On examination: The patient is limping with scoliotic stance. SLRS was
70 degrees in both sides with pain. Weak dorsiflexion left
foot 4/5. The right AJ is absent.
The lower half of the old
incision refreshed. Foraminotomy both S1 roots.
There was a huge ganglion compressing the right
S1 root, which was removed. The extruded disc
and upward migrating was removed lateral to the
left S1 root. The disc space of L5-S1 was
shallow and was not violated.
Routine closure of the wound.
Smooth postoperative recovery.
The power of the left foot became normal.
Comments
The estimated postoperative
recurrence rate around 0% because the disc space
of L5-S1 is severely shallow.
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