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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05-APRIL-2010 ISSA MUHAMED JADDALLAH
46 YEARS LUMBAR CANAL STENOSIS L4-5 WITH BILATERAL EXTRUSION.
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Anamnesis
The
patient came
to the clinic 03-April-2010 complaining of LBP
for 2 years with intermittent bilateral sciatica
and stiff both legs. He has intermittent
claudication and cannot walk more than 200
meters.
MRI Lumbar spine
performed 01-April-2010 showing lumbar canal
stenosis L3-4 and L4-5 with central extrusion
more to the left.
On examination: the
patient is limping with exaggerated
scoliotic stance. SLRS was 75 degrees both sides
with pain. There is weak dorsi and
planterflexion both feet 4/5.
Decompressive laminectomy L4
and partial of L3 and L5 was performed and
bilateral foraminotomy both L5 roots was
achieved. Bilateral cleaning of L4-5 with
removal of the extrusion was done. All the
compressive elements at both L3-4 and L4-5
levels were eliminated.
Routine closure of the wound.
Smooth postoperative
recovery, with
full recovery of the
power of both feet.
Comments
The roots were severely
compressed by the stenosis and the central
extrusion. This compression was gradual and
protracted over several months and the function
of the nerves was relatively acceptable. For
that reason the recovery was immediately full
after the surgery, in contrast to the one
operated yesterday, who will need several weeks
to regain acceptable recovery.
Lumbar canal stenosis is a
progressive disease, the sooner it is corrected,
the better the outcome.
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 .
