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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17-JUNE-2012 FIRYAL MUSA MUHAMED AL-EMERY 40 YEARS
HUGE EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic
19-April-2012 complaining of LBP for three
months with right sciatica and numbness both
hands awakening her during night.
On
examination, the patient has
waddling gait due to old CDH. SLRS was 40
degrees right and 30 degrees in the left with
more pain. There is weak dorsiflexion right foot
-4/5.
MRI lumbar spine done 25-April-2012 showed huge
extruded disc L5-S1 with right downward
migration.
The patient then came 26-May-2012 complaining of
neck pain for 2 days with right upper limb pain
with exaggerated weakness of the right upper
limb. MRI cervical spine performed 30-May-2012
showed old small extrusion of C6-7.
Right S1 foraminotomy with
reflection of the ligamentum flavum to the left.
The extruded disc was removed lateral to the
axilla. Subaxillary inspection of the fragments
revealed a piece, which was pushed up and
removed form the disc space. Right sided
cleaning of L5-S1 disc space. Guardix-sol was
applied around the root and the ligamentum
flavum returned to its original position.
Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of the
right foot.
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Comments
The patient still has an
estimated postoperative recurrence around 7%,
because the disc space is still not shallow.
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 .
