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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04-JUNE-2013 HAFEZ ISSA AL-TAMIMI 56 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient was operated for olfactory groove
meningioma
20-February-2010 and he was under follow up.
Then he came 03-June-2013 complaining of right
sciatica 4 days after lifting heavy object 3
weeks ago with numbness of the right foot.
MRI lumbar spine done 01-June-2013 showing
extruded disc L5-S1 with right foraminal
occlusion.
On examination: The patient is limping with
exaggerated scoliotic stance.
SLRS was 75 degrees with pain in the right. There is weak dorsi
and planterflexion right foot 3/5. Hypalgesia
right S1 territory.
Right S1 foraminotomy. The
extruded disc was severely compressing the root,
that it was not reachable lateral to the axilla,
nor subaxillary. The disc space was violated
lateral to the axilla to decrease the
compression to the root. The extruded disc was
removed lateral to the axilla. Right sided
intradiscal cleaning of L5-S1 disc space.
Routine closure of the wound.
Smooth postoperative recovery. The power of
right foot became normal.
Comments
The patient has severe hard compression of the
right S1 root. Surgical decompression is the
only solution.
The patient still have a 7% postoperative
recurrence rate because the disc space is still
not shallow.
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