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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09-NIVEMBER-2008 MAHER AHMAD ABDALLAH 38 YEARS
HUGE CENTRAL EXTRUDED DISC L5-S1 MORE TO THE LEFT.
Anamnesis:
The patient came to the
clinic 08-November-2008 complaining of LBP for 2
months. Left
sciatica 2 weeks after that.
MRI lumbar spine performed
10-September-2008 showed huge extruded disc L5-S1
central more to the left.
On examination: the patient
is limping with exaggerated scoliotic stance,
with SLRS 20 degrees in left side with pain and
weak dorsiflexion left foot 3/5 and
planterflexion 4/5.
Partial flavotomy L5-S1 left
side with foraminotomy left S1 root was
performed. The extruded disc was so sticky, that
it was necessary to perform intradiscal cleaning
of L5-S1 space, after what slight relaxation of
the dura was achieved. The extruded disc was
then removed lateral to the axilla. It was
rubbery in consistency. The root became lax and
further cleaning of the disc space was performed
from the left side.
Smooth recovery with prompt
improvement of the power of the left foot.
Comments
The patient had a rubbery
extrusion, making it difficult to remove it
directly. It was necessary to decompress the
intradiscal cavity to obtain some relaxation to
prevent traction injury to the already
compressed nerve.
The estimated recurrence rate
in this case is around 7% since the disc space
height is still not shallow.
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