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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01-MARCH-2009 ISA RASHED MARAQA 64 YEARS
RECURRENT PLD L5-S1 WITH SEVERE SEGMENTAL STENOSIS.
Anamnesis:
The patient came to the
clinic 22-February-2009 complaining of LBP with
severe right sciatica for 2 weeks. The patient
was operated elsewhere 1973 and 2002 for PLD
L4-5 and L5-S1.
On examination: the patient
is limping with exaggerated scoliotic stance,
using corset with weak right foot 3/5 in dorsi
and planterflexion. There is analgesia of the
right L5
and S1 territories.
MRI performed
23-February-2009 showing very large extruded
disc L5-S1 more to the right with segmental
stenosis.
Foraminotomy of the right S1
root was performed with guidance of
image-intensifier. There is a massive scar all
over. The disc space of L5-S1 was attacked
lateral to the axilla and the extruded
recurrence was removed and meticulous cleaning
of L5-S1 space was achieved. A huge amount of
extrusion with bony compression was removed fro
under the axilla, after what the dura became lax
and the root was free of any compression.
Routine closure of the wound after inspection
for CSF leak, which was negative.
Smooth postoperative
recovery.
Comments
Recurrence of disc is still a
problem even after many years of surgery. In
this case there was a bony part, which could be
for long time and new part which could be of
short duration. The severity of compression
mandate surgery.
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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 .
