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
The patient came to the clinic 11-May-2013
complaining of LBP with bilateral sciatica for 1
year with numbness both feet more the left foot
for 6 months and inability to walk more than 10
meters due to intermittent claudication. The
patient underwent discectomy L4-5 1995 and
cervical discectomy 2002.
MRI of the lumbar spine performed
28-February-2013 showed stenosis at L2-3,
L3-4.
On examination: the patient was limping with
exaggerated scoliotic stance. The right AJ was
absent. Weak dorsiflexion right foot -4/5 and
left foot 4/5. There is severe OA both knees
without pain. The patient was sent for
investigations.
ESR was 72 mm/h, CRP was 24 mg/L and dynamic
studies were normal. Vit D3 was low. MRI lumbar
spine done 10-June-2013 showing stenosis of L2-3
and L3-4 with extruded disc L3-4.
Decompressive laminectomy L3, upper half of L2
with removal of the remnant of L4. Foraminotomy
both L4 roots. Inspection of the disc of L3-4
from both sides. It was decided not to violate
it.
Smooth postoperative
recovery. The power of both feet became normal.
Comments
The patient has LCS which needs decompression.
The extrusion must be evaluated during surgery.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
