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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05-NOVEMBER-2008 MUHANAD MUHAMED SHOMALY 33 YEARS
HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 03-November-2003 complaining of LBP for 4
years with intermittent course. Left
sciatica for 6 months.
MRI lumbar spine performed
31-October-2008 showed huge extruded disc L5-S1
with left downward migration.
On examination: the patient
is limping with exaggerated scoliotic stance,
with SLRS 45 degrees in left side with pain and
weak dorsiflexion left foot -4/5 and hypalgesia
left S1 territory.
Partial flavotomy L5-S1 left
side with foraminotomy left S1 root was
performed. The downward migrating disc
material was removed under the axilla. There was
anomalous anatomical variation, that the left S1
was originating high and pushed lateral and the
left S2 root also originating high and pushed
medially. The disc space of L5-S1 was cleaned
meticulously from the left.
Smooth recovery with prompt
improvement of the power of the left foot.
Comments
The patient had anomalous
anatomical structures, that the surgeon must pay
attention during surgery.
The estimated recurrence rate
in this case is around 7% since the disc space
height is still not shallow.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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