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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07-JULY-2011 JAMAL HASAN MAHMUD JABER 67 YEARS
LUMBAR CANAL STENOSIS L3-4, L4-5 WITH EXTRUDED DISC L4-5 LEFT SIDE.
Anamnesis
The
patient was operated by me for PCD C3-4
28-July-2004 and did well. The patient then came
05-June-2008 complaining of LBP with
manifestation of lumbar canal stenosis and was
advised to undergo surgery, but he escaped. The
patient then came 02-July-2011 complaining of
left sciatica for 6 days after exposure to cold.
He could walk 1 Km, not limping with mild
scoliotic stance with intact sensation and power
both feet. The patient was given medications.
The patient then 06-July-2011 claimed that his
sciatica became agonizing and medication not
helping.
MRI
lumbar
spine done 06-July-2011 showing extruded disc
L4-5 left side with severe lumbar canal stenosis
at L3-4 and L4-5.
On
examination: the patient was unable to stand and
weak dorsiflexion left foot 4/5 was noted.
Decompressive laminectomy L4
and partial of L3 and 5 with foraminotomy of
left L5 root was achieved. The extruded disc was
removed from the left and bilateral cleaning of
the disc pace of L4-5 was achieved.
Routine
closure of the wound. Smooth postoperative
recovery with normalization of the power of the
left foot with disappearance of left
sciatica.
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Comments
The estimated postoperative recurrence rate is
around 7% because the disc space of L4-5 still
not shallow.
The patient was afraid of surgery, but the
agonizing pain pushed him to this kind of
treatment.
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 .
