Dr. Fuad Al-Masri Syrian neurosurgeon.

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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09-SEPTEMBER-2013  HAFEZ KHATTAB AL-HAMAYLEH  49 YEARS  EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 07-September-2013 complaining of LBP with left sciatica for 3 months down to all toes left foot with numbness. He is a known diabetic with glucophage 500 mg once a day. He is under treatment for Mediterranean fever with colchecine for 9 years.

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MRI of the lumbar spine performed 17-July-2013  showing extruded disc L4-5 with left downward migration and foraminal occlusion.

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On examination: the patient is limping with exaggerated scoliotic stance. There is weak dorsiflexion left foot  -3/5.  SLRS was 70 degrees in the left without pain, and 30 degrees in the right with pain. There is hypalgesia left L5 and S1 territories. 

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Using C-arm, the level of L4-5 identified. L4-5 flavotomy with left L5 foraminotomy was done. The extruded disc was removed lateral to the axilla of the right L5 root. Left sided cleaning L4-5 disc space. The downward migrating extrusion was removed at the end of surgery.

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Smooth postoperative recovery. The power of the left foot became normal.

 

 

Comments

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The patient still have an estimated postoperative recurrence around 7% because the disc space height still not shallow.

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The SLRS was negative at the side and positive at the contra-lateral side.

 

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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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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