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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23-JULY-2013 KAWTHAR FAHEEM SALEH 43 YEARS EXTRUDED DISC L4-5
CENTRAL WITH SEGMENTAL STENOSIS.
The patient came to the clinic 08-June-2013
complaining of LBP with left sciatica for one
year with numbness left foot the last 45 days.
The patient is a known SLE patient for 23 years.
On examination: the patient is limping due to
old injury to the right Achill's tendon 7 years
exaggerated scoliotic stance. SLRS was 85
degrees both sides. AJ was absent both sides and
preserved AJ in the left side. Weak dorsiflexion
left foot -4/5.
The patient came 27-June-2013 with MRI lumbar
spine bad quality done 18-May-2013 showing
extruded disc L4-5 with left foraminal
occlusion. The MRI was repeated 27-June-2013
showing extruded central disc L4-5 more to left
in its upper part and down more to the right.
The patient was advised to try conservative
treatment, but she came 22-July-2013 in
agonizing bilateral sciatica the last 2 days
with inability to stand and walk. SLRS was 60
degrees in the right and 70 degrees in the left
with pain. There is weak dorsiflexion right foot
4/5 and left foot -4/5. Hypalgesia left L5 and
Partial laminectomy L4 and
L5. Bilateral foraminotomy both L5 roots. The
extruded disc attacked from lateral to the left
axilla. Bilateral intradiscal cleaning L4-5 disc
space. The disc material was inflammatory and
soft in consistency, friable. The was no
epidural fat due to severe compression.
Routine closure of the wound.
Smooth postoperative recovery. The power of both
feet became normal with regression of the
The patient still has an estimated postoperative
recurrence around 7%, because the disc space is
still not completely shallow.
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