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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18-APRIL-2011 AMER MASHHUR KOKH 31
YEARS HUGE PLD L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The
patient came to the clinic 06-April-2011
complaining of LBP for 1 year with left
agonizing sciatica for 4 days with numbness of
the left S1 territory.
On
examination: the patient limping with
scoliotic stance. SLRS was 40 degrees left side with
pain. There is weak dorsiflexion left foot 4/5
with dysesthesia of the left S1 territory.
The
patient was sent for MRI lumbar spine and done
13-April-2011 showing huge extruded disc L5-S1
with left downward migration.
Left S1 foraminotomy with partial flavotomy was
done. The extruded disc was removed lateral to
the axilla in several pieces. There was rich
venous structures, that needed to coagulate to
achieve good heamostasis. Left sided cleaning
L5-S1 disc space. Subaxillary inspection for
remnants did not reveal presence of such
fragments.
Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of left
foot.
The patient is a known cartoonist and he draw this piece
of art about his preoperative suffering/ After his
permission.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
connection.
Comments
The agonizing pain is pushing the patient to
undergo surgery. He was afraid of surgery and he
was advised to undergo it, and he escaped then
he came, urging to perform the surgery as soon
as possible.
The estimated recurrence rate is around 7%
because the defect in the annulus fibrosis was
wide.
After surgery- The patient got better.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
