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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12-APRIL-2008 MAHMOUD MUHSEN AL-KOOZ
40 YEARS EXTRUDED DISC L4-5 LEFT SIDE.
Anamnesis:
The patient came to the
clinic 10-May-2003 complaining of both shoulders
pain and neck and right upper limb pain. The
patient was treated conservatively and escaped
until 08-April-2008 came with LBP for 2 months
and left sciatica.
SLRS was 70 degrees in the
right and 30 degrees in the left with pain.
Limping when walking and exaggerated scoliotic
stance. He had weak dorsiflexion both feet, more
in the left and planterflexion left foot.
MRI of the lumbar spine
performed 09-April-2008 showed extruded disc
L4-5 with left foraminal occlusion.
Left L4-5 hemiflavotomy with
left L5 root foraminotomy was done. The extruded
disc was removed lateral to the axilla and left
sided cleaning of the L4-5 space was achieved.
Routine closure of the wound
with smooth postoperative recovery.
Considerable improvement of the
power of the left foot.
Comments
The disc space height is
still considerable, for what meticulous cleaning
was performed to decrease the expected
recurrence rate, which still remain above the
average.
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