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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02-MARCH-2008 ISSA MINWER AL-SALAYTAH 36 YEARS
VERY HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 12-February-2008 complaining of LBP for
20 days with left
sciatica and numb left foot with positive cough sign.
MRI
lumbar spine done 04-February-2008
showing huge PLD L5-S1 with left downward
migration.
On examination: the patient
is limping and dragging his left leg and has scoliotic stance. SLRS was
50
degrees in the right and 25 degrees in the left
with radiating pain to the left leg. The
patient had weak dorsiflexion left foot
4/5 and hypalgesia left S1 territory.
Foraminotomy of left S1 root
was performed and partial flavotomy of L5-S1 was
done. The extruded disc was removed from under
the axilla in three successive big pieces.
Inspection of the disc space, confirmed that the
disc space was practically obliterated, for what
it was decided not to violate it.
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the left foot.
Comments
Foraminotomy of the involved
root must be done in all disc surgeries to be
sure that there is no remnant left under the
axilla.
The disc space was very
shallow, for what the expected recurrence rate
in this case is almost zero.
