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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02-JULY-2013 FAHED ABDALLA HUSSEIN AL-KULABI 27
YEARS EXTRUDED DISC L3-4 WITH WITH DOWNWARD MIGRATION MORE TO THE LEFT.
Anamnesis
The patient came
to the clinic 01-July-2013 complaining of LBP
for 45 days with left sciatica and drop left
foot for 4 week.
MRI lumbar spine done 18-May-2013
showed huge extruded disc L3-4 with severe
stenosis at this level.
On examination: The patient was limping with
exaggerated scoliotic stance. Using crutches for
3 weeks. SLRS was 10
degrees with pain in the right and zero degree
with more pain in the left. Weak
dorsiflexion right foot 3/5. Complete drop left
foot with weak paralysis of planterflexion 1/5. There
is
analgesia left L5 root.
The patient was sent for new
MRI which was done 01-July-2013 showing the
extrusion of L3-4 with severe segmental canal
stenosis L3-4 and L4-5..
Decompressive laminectomy L3,
L4 and upper 1/4 of the L5. Foraminotomy L4, L5
roots both sides. Cleaning of the extruded disc
of L3-4 with intradiscal cleaning L3-4.
Routine closure of the wound.
Smooth postoperative recovery.
The power of
right foot became better and slight improvement
of the left foot.
Follow Up
The patient progressed discitis
06-September-2013, for what conservative
treatment plan for 6 months was started.
Comments
The patient still has an estimated postoperative
recurrence around 7%, because the disc space is
still not shallow.
The flail left foot require several weeks to
recover.
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