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-AUGUST-2013 ADILA ADEL AL-TAHER 69 YEARS
EXTRUDED DISC L3-4 WITH LEFT FORAMINAL OCCLUSION.
Anamnesis
The patient came 13-August-2013 complaining of
LBP for 45 days with left sciatica down to all
toes left foot. She is a known hypertensive with
edema both lower limbs more the left with
varicose veins both legs, more the left.
MRI lumbar spine done 30-June-2013 showing bulge
L2-3, L4-5 with extruded disc L3-4 causing
left foraminal compression.
On examination the patient is limping with
exaggerated scoliotic stance. SLRS was 30
degrees in the left with pain. Weak dorsiflexion
left foot 4/5.
MRI lumbar spine performed 14-August-2013
showing extruded disc L3-4 with left foraminal
occlusion and bulge L2-3 and L4-5 with segmental
at these levels.
Using C-arm, the level of
L3-4 was identified. Left L3-4 hemiflavotomy
with foraminotomy left L4 root. The extruded
disc L3-4 was removed lateral to the axilla and
left sided intradiscal cleaning L3-4 was
achieved.
Smooth postoperative
recovery. The left sciatica disappeared and the
power left foot became normal.
Comments
The patient still having an estimated
postoperative recurrence around 7%, because the
disc space height still not shallow.
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