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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27-JANUARY-2011
NAHILA AHMAD AL-JILANY 56 YEARS EXTRUDED DISC L4-5 WITH SEVERE COMPRESSION
OF LEFT L5 ROOT.
Anamnesis
The patient
came to the clinic 25-January-2011 complaining
of LBP with left sciatica for 2 months without
improvement.
MRI lumbar
spine performed 03-January-2011 showing extruded
disc L4-5 with severe compression of the left L5
root.
On
examination: The patient is walking with
help, limping with exaggerated scoliotic stance
with agonizing pain. She has weak dorsi
and planterflexion left foot -3/5. SLRS was 5
degrees in the left with pain. There is
analgesia of the left L5 root territory.
Left L5 foraminotomy with partial flavotomy of
L4-5 was done. The left L5 root was severely
compressed. The extruded disc was removed
lateral to the axilla and left sided cleaning of
L4-5 disc space was achieved. Some fragments of
the extrusion were removed from under the
axilla.
Routine
closure of the wound. Smooth postoperative
recovery with normalization of the power of left
foot.
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Comments
The disc space height is
slightly shallow, which indicate the small
possibility of disc recurrence.
So as to avoid mechanical trauma to the
already compressed root, partial intradiscal decompression
was performed to decrease the pressure applied to the root,
before removing the extrusion.
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 .
