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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18-FEBRUARY-2012 MABRUKA AHMAD AL-AZHARY 53 YEARS
HUGE CENTRAL EXTRUDED DISC L4-5 WITH SEGMENTAL STENOSIS.
Anamnesis
The
patient came to the clinic
29-January-2012 complaining of LBP, neck pain
for 16 years with bilateral sciatica, both knees
pain for 2 years, tinnitus left ear and left
ophthalmalgia for 2 years. The patient is a
known diabetic for 4 years and she underwent
discectomy L5-S1 2002 in Tunisia for left
sciatica.
On
examination: the patient limping and have
exaggerated scoliotic stance. There is no
sensory deficit with weak both upper limbs below
the biceps muscle 4/5.There is weak dorsi and
planterflexion left foot 3/5 and mild weak both
quadriceps muscles 4/5.
The
patient was sent for whole neuroradiologic
investigations, which done 31-January-2012 and
revealed small central extruded disc C4-5 and
huge central extruded disc L4-5 with severe
segmental stenosis. There was also sinusitis of
the left maxilla.
Decompressive laminectomy of
L4 and partial of L5. Bilateral flavotomy L4-5
with bilateral L5 root foraminotomy. The
extruded disc was removed from both sides.
Bilateral cleaning of L4-5 disc space.
Routine
closure of the wound. Smooth postoperative
recovery with normalization of the power of both
feet.
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Comments
The patient still
have estimated postoperative recurrence rate around 7%,
because the disc space still not shallow.
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 .
