Munir Elias 20-12-2013

Dr. Ali Al-Bayyati and Dr. Munir Elias

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-SEPTEMBER-2012  MANSOUR ALI AL-KAHTANY  68 YEARS  LUMBAR CANAL STENOSIS L2-3, 3-4 AND L4-5.

 

Anamnesis

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The patient came to the clinic 08-September-2012 complaining of minimal LBP and bilateral sciatica more the right more than 4 years and inability to walk more than 50 meters with intermittent claudication for three years and a progressive course the last year.

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MRI lumbar spine done 03-September-2012 showing LCS L2-3. L3-4 and L4-5 with vacuum phenomenon at the involved disci.

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On examination, the patient is limping with shuffling gait. SLRS was 90 degrees both sides. There is hypotonia both feet. There is weak dorsiflexion right foot 3/5 planterflexion right foot and dorsiflexion left are -4/5. There is hypalgesia below the left knee.

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The patient was sent for cardio evaluation and cath done 11-September-2012 and showed that there was an old stent which was inserted 8 years ago and there are several mild stenotic changes of no major importance.

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Laminectomy of L3,4 and upper half of L5 and lower half of L2. All compressive elements were eliminated and foraminotomy of right L3,4 and L5 roots was performed. The epidural fat was missing at all levels.

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Routine closure of the wound. Smooth postoperative recovery and the power of the feet became normal.

 

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Comments

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The patient has progressive lumbar canal stenosis. The sooner the surgical decompression the better the outcome.

 

 

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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 .

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