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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11-FEBRUARY-2010 JIHAN RATEB NAASAN 32 YEARS
HUGE CENTRAL EXTRUSION L5-S1 MORE TO THE RIGHT.
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Anamnesis
The patient came to the
clinic 09-February-2010 complaining of LBP
for 1 year. Sever right sciatica took place the
last month.
On examination: the patient is
limping with no scoliosis. SLRS was 30 degrees
in the right and 40 degrees in the left. The AJ
is absent in both sides with weak dorsiflexion
-4/5 and planterflexion 4/5 of the right foot
MRI lumbar spine requested and
done 10-February-2010 showing very huge central
disc L5-S1 more to the right.
Right sided hemiflavotomy of L5-S1 and
right foraminotomy of S1 root was achieved.
The extruded disc was removed lateral to the
axilla and right sided cleaning of L5-S1 disc
space was achieved.
Using PEEK
Satellite spinal system, was not necessary
because the disc space was shallow.
Routine closure of the wound.
Smooth postoperative
recovery, with
normalization of the power of the right foot.
Comments
The surgeon think
that he performed meticulous cleaning of the
disc space, but it is not true. It is impossible
to clean the disc space from even both sides, using the
available standards.
The shallow disc
space means minimal disc recurrence, for what
the idea of nucleus replacement device was
abandoned in this case.
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 .
