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-JULY-2009 MAJED KHAYEF AL-ENEZY 22 YEARS
HUGE CENTRAL DISC L4-5 MORE TO THE LEFT.
Anamnesis:
The brother of the patient
from Saudi Arabia came to the
clinic 25-June-2009 telling that his brother is complaining of LBP and
left
sciatica for 3 weeks with numbness of the left
foot.
On examination: the
patient is limping with
scoliotic stance, SLRS
was 30 degrees in the
left with pain and
weak dorsiflexion both
feet 4/5 and
planterflexion left foot
4/5 with hypalgesia
of left L5 and S1 territories.
MRI lumbar
spine performed 14-June
showing
huge extruded disc
L4-5 more in the left
with downward migration.
Left hemiflavotomy of
L54-5 and foraminotomy
of left L5 root was
performed and removal of
the extrusion was
achieved lateral to the
axilla and meticulous
cleaning of L4-5 disc
space was performed.
Considering the age of
the patient and still
not shallow disc space
height, the Satellite
PEEK nucleus replacement
sphere was suggested to
the patient, but he
refused it.
Routine closure of the
wound.
Smooth postoperative recovery
with improvement of the power of the left foot.
Comments
The expected recurrence in
this case is above 7% and insertion of the
replacement nucleus was an ideal solution to
decrease this figure, but the patient refused to
perform such procedure.
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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 .
