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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26-AUGUST-2013 MAHMOUD AHMAD QUTNA 50 YEARS
EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
The patient was admitted directly to the
operating room with agonizing left sciatica for
4 weeks with LBP which subsided then
exacerbation the last 10 days.
MRI of the lumbar spine performed 19-August-2013 showing
huge extruded disc L5-S1 with left downward
migration. The S1 is lumbarized.
On examination: the patient cannot walk or stand
with agonizing sciatica. There is weak dorsi and
planterflexion left foot -4/5. There is numbness
of the left foot.
Considering that the patient
has lumbarization of S1, the C-arm was used to
identify the L5-S1 level. Fenestration of the
left L5-S1 with partial flavotomy and
foraminotomy of left S1 root. The extruded disc
was pushing the root medially. The extruded disc
was removed lateral to the axilla. Left sided
cleaning L5-S1 with removal of the hard parts of
the slipped annulus fibrosis. The root became
recovery. The power of the left foot became
The patient still have an estimated
postoperative recurrence around 7% because the
disc space height still not shallow.
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