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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30-AUGUST-2012 KHERIYE MUHAMED AL-HMEDAT 65 YEARS
SEVERE LUMBAR CANAL STENOSIS L4-5.
The patient came to the clinic
26-August-2012 complaining of LBP for 5 years
with bilateral sciatica for one year in the left
and 1 month in the right.
MRI lumbar spine performed 23-August-2012
showing bulge L2-3, 3-4, 4-5 with severe canal
stenosis L4-5 and to lesser degree of the L2-3.
On examination, the patient is limping with
exaggerated scoliotic stance, using crutches for
one year. SLRS was 70 degrees with pain in the
right. There is weak dorsiflexion both feet -4/5
and planterflexion right foot -4/5. Hypalgesia
right L5 and S1 territories. There is OA both
knees without local pain.
Laminectomy L4 and L5. There
is severe stenosis mostly at L4-5 level. The
ligamentum flavum and ligamentous structures of
the lateral masses were severely adherent to the
dura, for what sharp dissection was applied to
avoid tear of the transparent dura. Foraminotomy
of both L5 roots. Inspection of the annulus
fibrosis of L4-5 revealed no extrusion, for what
it was decided not to violate the disc
Routine closure of the wound. Smooth
postoperative recovery and the power of
both feet became normal.
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The patient has severe
lumbar canal stenosis. The sooner the surgical
decompression the better the outcome.
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