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-MAY-2010 FATIMA IZZAT ABDEL-HADY 52 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The
patient came
to the clinic 29-December-2009 complaining of
LBP for 9 years with right sciatica for one year
down to the heel of the right foot.
MRI lumbar spine performed 16-September-2009
showing extruded disc L5-S1 central more to the
right.
On examination the
patient can walk more than 1Km with SLRS 80
degrees both sides with weak dorsi and
planterflexion right foot 4/5.
The patient was
advised to keep in conservative measures and if
she deteriorate in the future then to reevaluate
her condition.
The patient then
came 12-May-2010 claiming that her condition is
deteriorating and the weak planterflexion right
foot became 3/5 with hypalgesia right S1 root
territory. SLRS was 75 degrees in the right with
pain. The patient is limping with exaggerated
scoliotic stance.
The patient was sent
to new MRI which was performed and demonstrating
extruded disc L5-S1 with right foraminal
occlusion.
Right L5-S1 hemiflavotomy with right S1
foraminotomy was achieved. The extruded disc was
removed after what the right S1 root became lax.
Further meticulous cleaning of L5-S1 space was
performed from the right side.
Smooth postoperative recovery and the power of
the right foot became normal..
Comments
The patient had
extruded disc at the start, not convincing for
surgical treatment. Later escalation of the
events shifted the decision in favor to
surgical treatment.
In this case the disc space
still not shallow, that the estimated
postoperative recurrence is around 7%.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
