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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07-SEPTEMBER-2011 GHALEB AHMAD SHALASH 41 YEARS EXTRUDED DISC L4-5
LEFT FAR-LATERAL.
Anamnesis
The
patient came to the clinic 04-September-2011
complaining of LBP since 20-July-2011 with left
sciatica . MRI lumbar spine done 30-July showing
disc L4-5 with left far-lateral extrusion.
On
examination: the patient is limping with
exaggerated scoliotic stance. There is weak dorsi
and planterflexion
left foot
-4/5. SLRS was 75 degrees in the left side with
pain.
MRI lumbar
spine was repeated recently showing extruded
disc L4-5 with left foraminal occlusion and
far-lateral location, for
what surgery was advised.
Left L5 root foraminotomy
done. Left hemiflavotomy L4-5 achieved.
The left far-lateral extrusion was removed in
several pieces. The upward migrating pieces were
also removed. Left sided cleaning L4-5 disc
space was performed. Inspection for remnants of
the far-lateral extrusion revealed no
residual fragments.
Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of
left foot.
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Comments
The estimated recurrence in this case is 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 .
