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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25-APRIL-2013 AMEEN SALTI QAQISH 32
YEARS HUGE EXTRUDED DISC L4-5 WITH WIDE BASE AND RIGHT
FORAMINAL OCCLUSION.
Anamnesis
The patient is a doctor came
to the clinic 06-April-2013 complaining of LBP
for 4 months with right sciatica down to
the lateral malleolus right ankle. MRI of lumbar
spine done 03-April-2013 showing huge extruded
disc L4-5 wide based compressing the right L5
root with right downward migration.
On examination: The patient is limping with
exaggerated scoliotic stance.
SLRS was
20 degrees right side with pain and 80 degrees in the left
. There is weak dorsiflexion right foot -4/5 and
dorsiflexion left foot and planterflexion right
foot 4/5. The right AJ is diminished.
Using C-arm, the L4-5 level
was identified and right L4-5 hemiflavotomy was
done and right L5 root foraminotomy achieved.
The area was lacking an epidural fat due to
severe compression. The extruded disc was
removed lateral to the axilla. Right sided
cleaning of L4-5 disc space.
Routine closure of the wound.
Smooth postoperative recovery. The power
of right foot became normal.
Comments
The patient still has an estimated postoperative
recurrence below 7%, because the disc space is
still not completely shallow.
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