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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26-JULY-2013 GHASAN MITHQAL DHEMISH 40 YEARS HUGE EXTRUDED
RECURRENCE L5-S1 WITH RIGHT FORAMINAL COMPRESSION.
Anamnesis
The patient was operated by me
18-March-2013 for huge extruded disc L5-S1
with foraminal occlusion. He is living in
Vietnam and after arriving there, he started to
complain of the same sciatica and he was advised
to repeat MRI which was not done. The patient
then came 21-July-2013 telling that the sciatica
disappeared the last month, but he continued to
complain of LBP when standing and turning.
On examination: the patient is not limping with
less scoliotic stance. SLRS was 90
degrees both sides. There is no motor or sensory
deficit.
The patient was sent for new MRI lumbar
spine which was done 22-July-2013 showing huge
recurrence of L5-S1 with right foraminal
occlusion and upward migration.
Scarolysis with foraminotomy
right S1 root. The extruded disc with slipped
annulus fibrosis were removed lateral to axilla.
Right sided intradiscal cleaning L5-S1 disc
space. It seems the patient has minor degree of
L5-S1 spondylolisthesis.
Routine closure of the wound.
Smooth postoperative recovery. The patient
showed escalation of an agonizing left sciatica
and the sciatica of the right side disappeared.
Comments
The patient still has an estimated postoperative
recurrence less than 7%, because the disc space is
shallow, but still not complete.
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