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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01-MAY-2008 ISMAEEL ODEH ISSA 40 YEARS EXTRUDED
DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 28-April-2008 complaining of LBP for 3
months with left sciatica.
MRI performed 21-February-2008
showed extruded disc l4-5 with left
downward migration.
On examination: the patient
is limping and using crutches for ambulation with scoliotic stance. SLRS was
80 degrees in the
right and 20 degrees in the left with pain.
He had weak dorsi and planterflexion left foot
3/5 with hypalgesia left L5 and S1 territories.
Left L4-5 hemiflavotomy with
left L5 root foraminotomy with removal of the
extrusion lateral to the axilla was performed.
Left sided intradiscal meticulous cleaning of
L4-5 was done. It was necessary to remove the
hard part of the annulus fibrosis, which was
compressing the running root to eliminate the
compressive elements. By doing this the defect
of the annulus fibrosis became wider.
Routine closure of the wound
with smooth postoperative recovery.
Considerable improvement of the
power of the right foot.
Comments
The expected recurrence is
higher because the disc space is still having
considerable height and
the defect in the annulus fibrosis left wide.
In case of recurrence the
lateral mass was drilled more far-lateral, to
give an ambience in case of recurrence to avoid
severe pain in such possible future event.
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