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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22-AUGUST-2013 BASEM MAHMOUD AL-LOWZI 54 YEARS
EXTRUDED DISC L4-5 WITH BILATERAL SCIATICA.
The patient came 20-July-2010 complaining of LBP
with bilateral sciatica for 1 year. The last
month at that time, got neck pain and pain right upper limb
with numbness of the index finger right hand.
The patient was not limping with
weak grip and extension of the right hand and
weak triceps muscle right side 4/5. There was
hypalgesia index right hand. MRI cervical done
21-July-2010 showed small extrusion C5-6, C6-7
and the patient was treated conservatively.
The patient then came 14-August-2013 telling
that the LBP exacerbate the last 2 months with
bilateral sciatica, more the right. The patient
is limping walking bended anterior with
exaggerated scoliotic stance.
On examination the patient has weak dorsiflexion
both feet 3/5 and planterflexion both feet +3/5.
SLRS was 25 degrees right and 35 degrees left
with pain more in the right. AJ was absent both
sides. The patient is diabetic.
MRI lumbar spine performed 17-August-2013
showing wide based extruded disc L4-5 with
downward migration, more to the left resulting
in segmental stenosis at this level.
Laminectomy L4 with
foraminotomy both L5 roots. Bilateral cleaning
L4-5 disc space.
recovery. The power of both feet became normal.
The estimated postoperative recurrence is
around7-15% because the disc space height is
still high. In case of recurrence fusion is
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