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-SEPTEMBER-2012 FADWA MAHMOUD WAHDANI 41 YEARS
HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 13-September-2012
complaining of agonizing LBP and left sciatica
for 45 days down to the left S1 territory with
numbness of the foot with positive cough sign without any improvement.
On examination, the patient is limping with
exaggerated scoliotic stance. SLRS was 40
degrees in the left with severe pain. The left
AJ is absent. There is weak dorsi and
planterflexion right foot -4/5. There is
numbness of the III to V toes left foot.
MRI lumbar spine done 13-September-2012 showing
huge extruded disc L4-5 with left downward
migration with secondary segmental stenosis.
Left L4-5 hemiflavotomy with L5 foraminotomy.
The major part was
removed lateral to the axilla. Left sided
cleaning L4-5 disc space. The dura and the root
were lacking epidural fat due to severe
pressure.
Routine closure of the wound. Smooth
postoperative recovery and the power of the
left foot became normal and the sciatica
disappeared.
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Comments
The patient was in
agonizing pain because the extrusion was big and
severely compressing the root.
The patient still have an estimated
postoperative recurrence rate around 7% because
the disc space is still not shallow.
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