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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07-APRIL-2013 AFAF YOUNIS ABU-JUDEH 41 YEARS
EXTRUDED RECURRENT DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came
to the clinic 04-April-2013 in agonizing LBP
with left sciatica the last 3 days with positive
cough sign. The patient underwent discectomy
L5-S1 1999 for for left sciatica and 2003 for
right sciatica.
MRI lumbar spine done 04-April-2013 showing huge
extruded recurrent disc L4-5 with left downward
migration.
On examination: The patient is limping. She
cannot stand to evaluate the scoliotic stance,
nor normally sleep for proper clinical
evaluation. SLRS was 80 degrees in the right and
5 degrees with shooting pain in the left. Almost
drop left foot with weak planterflexion left
foot 3/5. Weak dorsiflexion right foot 4/5 with
analgesia of the left L5 territory and
hypalgesia of the left S1 territory.
Left L4-5 hemiflavotomy with
left L5 root foraminotomy. The huge extruded
disc material was removed from under the axilla
in one big piece. Left side cleaning of the L4-5
disc space.
Routine closure of the wound.
Smooth postoperative recovery.
Comments
There is still an estimated postoperative
recurrence rate around 7% because the disc space
of L4-5 still not shallow.
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