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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18-MARCH-2013 GHASAN MITHGAL DHEMISH 40 YEARS
HUGE EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient came to the clinic 31-December-2012
complaining of LBP for 12 months with both
hip pain.
MRI lumbar spine done 18-January-2012 not
informative.
On examination: The patient is limping with
exaggerated scoliotic stance. SLRS was 70
degrees in the right and 80 degrees in the left.
There is weak dorsiflexion right foot 4/5.
The patient was sent for thorough investigations
and MRI lumbar spine done 31-December-2012
showing huge extruded disc L5-S1 with right
foraminal occlusion. Dynamic studies were
negative.
Foraminotomy right S1 root
with reflection of the ligamentum flavum to the
left side. The patient has no signs of
spondylolisthesis L5-S1 but the lamina is flail,
which could be to previous trauma. The extruded
huge disc was removed lateral to the axilla in
several pieces after what the root became lax.
The disc space was very shallow and empty.
Routine closure of the wound.
Smooth postoperative recovery. The power of
the right foot became normal.
Comments
There is still an estimated postoperative
recurrence below 7%, because the disc space is
shallow.
It is not clear why the lamina of L5 was flail
and how clinically this fact is important. The
postoperative follow up will give the answer.
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