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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24-NOVEMEBR-2012 FATHI MUHAMED AHMAD NAJEM EXTRUDED DISC
L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 22-November-2012
complaining of agonizing left sciatica for 10
days with positive cough sign. MRI lumbar spine
spine done today showing bulge L4-5 and huge
extruded disc L5-S1 with left downward
migration. Dynamic studies were normal.
On examination: the patient is limping,
bended anterior
and dragging the left leg with
exaggerated scoliotic stance. SLRS zero degrees
in the left side with pain. There is
weak dorsiflexion left foot -4/5. The left AJ is
diminished in comparison to the right.
Left L5-S1 flavotomy with
foraminotomy left S1 root. The extruded disc
with downward migration was hard in consistency
and with difficulty was mobilized from the
axilla. It was necessary to remove it in
piece-meal fashion and discectomy of L5-S1 was
done with trail to push the extrusion to the
disc space with subsequent removal. The root
became lax and free.
Routine closure of the wounds. Smooth
postoperative recovery. The power of the left
foot
became normal.
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Comments
The patient still has
an estimated postoperative recurrence below 7%,
because the disc space is relatively shallow.
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