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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13-APRIL-2009 HILAL AHMAD ABU-DALLU 31
YEARS EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis:
The patient was admitted to
Shmaisani hospital 09-April-2009 with history of
RTA 1 month ago with agonizing right sciatica
the last 4 days.
On examination: there is weak
dorsiflexion and planterflexion right foot with
hypalgesia right S1 territory. SLRS was zero in
the right.
The patient was sent for MRI
lumbar spine with MR Myelography which was
performed 10-April-2009 showing extruded disc
L5-S1 with right downward migration.
Right S1 foraminotomy was
performed and the extruded disc of L5-S1 was
removed in several pieces lateral to the axilla.
Meticulous cleaning of the disc space was
achieved from the right. The root is hanging free.
The epidural fat was transferred to cover the
root. Routine
closure of the wound.
Smooth postoperative
recovery with prompt recovery of the power of
right foot.
Comments
The expected recurrence rate
in this case is around 7%, because the disc
space of L5-S1 is not shallow and the defect of
the annulus fibrosis is medium in size.
Transfer of the epidural fat
with pedicle to cover the root is the best
option to prevent postoperative adhesions at the
root zone.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
