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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11-APRIL-2012 MARIAM FAYYAD AL-LOZY 50
YEARS EXTRUDED WIDE-BASED DISC L5-S1 WITH RIGHT DOWNWARD
MIGRATION.
Anamnesis
The
patient came to the clinic 07-April-2012
complaining of bilateral sciatica for one year
with LBP.
MRI lumbar spine performed 20-Fibruary-2012
showing huge wide-based extruded disc L5-S1 with right foraminal
and downward migration.
On
examination, the patient in agonizing pain
with exaggerated scoliotic stance and limping. SLRS was
80
degrees in both sides. There
is profound weakness right foot dorsi and
planterflexion -4/5 and weak dorsiflexion left
foot -4/5.
Bilateral foraminotomy of S1 roots. The extruded
disc was removed first from the right side. Left
sided removal was followed, then bilateral
cleaning of the L5-S1 disc space was achieved.
The calcified movable parts of the deformed
annulus fibrosis were removed also. The axillae
were located at the level of the upper border of
the disc space, for what most of the disc
material was removed subaxillary from both
sides.
Routine
closure of the wound. Smooth postoperative
recovery. The power of both feet became
normal.
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Comments
The estimated
postoperative recurrence rate still around 7%,
because the disc space is still not shallow.
In this case bilateral
removal of the extrusion was mandatory.
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 .
