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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05-MAY-2012 FATMEH FAYYAD AL-LAWZY 55 YEARS SEVERE
LUMBAR CANAL STENOSIS L3-4, L4-5.
Anamnesis
The
patient came to the clinic 25-April-2012
complaining of numbness both feet for 5 years
with intermittent claudication and inability to
walk more than 50 meters. The condition is
deteriorating and having LBP with bilateral
sciatica. MRI lumbar spine performed
09-January-2009 showing severe stenosis L3-4 and
L4-5.
On
examination, the patient is limping with
exaggerated scoliotic stance with SLRS 70
degrees with pain in the right side. There is
weak dorsi and planterflexion both feet 4/5.
The right KJ and left AJ are absent. The pedis
dorsalis and femoral pulses were impalpable.
The
patient was sent for new MRI lumbar spine and
CT-angio of the aorto-ilio-femural arteries.
They were performed 27-April-2012 showing good
filling of all arteries, except the pedis
dorsalis and severe stenosis L3-4 and L4-5.
Decompressive laminectomy
L3,4 and upper half of L5. Flavotomy L2-3 and
foraminotomy L4, L5 roots both sides. The
epidural fat was missing all over. No signs of
instability. The disc structures were
acceptable, not violated. The roots hanging
free.
Routine
closure of the wound. Smooth postoperative
recovery. The power of the feet
normalized.
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Comments
The patient has lumbar
canal stenosis of a progressive course. Surgical
decompression is the only solution in this case.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
