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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KHETAM SULAYMAN MARAR 50 YEARS SECOND RECURRENCE OF L5-S1 LEFT SIDE WITH
TOTAL COLLAPSE OF DISC SPACE.
The patient came to the clinic 13-October-2012
complaining of LBP for three years, bilateral
sciatica and numbness of both feet more the
right for one month. Cannot walk more than 100
meters due to pain with positive cough sign. The
patient is hypertensive for 15 years and cath
done 2010 which was normal. The patient had RTA
6 years ago.
MRI lumbar spine done 18-September-2009 showing
spondylolisthesis L4-5 with secondary stenosis
and bulge L5-S1.
On examination: the patient
is limping with
exaggerated scoliotic stance. SLRS
was 75 degrees both sides with pain in the right. There is weak
dorsiflexion both feet -4/5 and the right foot
planterflexion 4/5. There is hypalgesia right L5
and S1 roots.
New MRI lumbar spine
requested and done 04-November-2012 showing II
degree spondylolisthesis L4-5 with complete
stenosis at this segment with bulge L5-S1.
Decompressive laminectomy L4
and partial of L5. Foraminotomy both L5 roots.
Right L4-5 discectomy with insertion of TLIF
cage Novel TL 9x24x15 mm with bone graft. Using
Isobar pedicular screw system- Scientex 6.2x40
mm ployaxial screws were inserted to the L5
pedicles and 6.2x40 mm monoaxial to the L4
pedicles. 2 rods 5.5x65 mm and cross connector
were used with slight compression to fuse the
L4-5 level. Bone graft Lifeline was used
parallel to the rods.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
feet became normal and the right sciatica
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The patient has severe
lumbar canal stenosis due to spondylolisthesis
L4-5 with progressive course. Surgical
correction both problems is the only solution.
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