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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05-OCTOBER-2011 KAMAL SULAYMAN AL-DARDESY 63 YEARS
HUGE EXTRUDED DISC L4-5 WITH LEFT UPWARD MIGRATION.
Anamnesis
The
patient came to the clinic 02-October-2011
complaining of LBP with left sciatica for 6
months with exacerbation last 20 days down to
the medial malleolus. The patient is a known
diabetic for 25 years in insulin.
MRI lumbar
spine performed 22-September-2011 showing huge
extruded disc L4-5 with left upward migration,
resulting in severe lumbar canal stenosis.
On
examination: the patient is limping, using
crutches for 10 days, has
exaggerated scoliotic stance. He cannot sleep
supine due to pain. There is weak dorsi
and planterflexion left foot
-3/5 and weak dorsiflexion right foot -4/5. SLRS was
80 degrees in left side
with pain.
Bilateral L4-5 flavotomy with
foraminotomy both L5 roots was achieved. The
extruded upward migrating disc was removed from
the left side in several pieces. Bilateral
cleaning of L4-5 disc space was performed.
Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of
left foot.
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Comments
The estimated postoperative recurrence in this
case is above 7%, because the disc space is
still high, even bilateral cleaning was
performed.
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 .
