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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03-JULY-2012 NASER WAJEEH MUSTAFA 50 YEARS
HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to emergency Shmaisani hospital
01-July-2012
complaining of severe sudden LBP with left
sciatica for 4 days with difficult walking.
MRI
lumbar spine performed 26-June-2012 showing
huge extruded disc L5-S1 with left downward
migration.
On
examination, the patient have is limping with
exaggerated scoliotic stance. SLRS was 60
degrees in the right and 30 degrees in the left
with pain. There is weak dorsiflexion both feet
4/5 and planterflexion left foot 4/5 with
hypalgesia left L5 root territory.
Left S1 foraminotomy with
reflection of the L5-S1 ligamentum flavum to the
right. The left S1 root was severely compressed.
The downward migrating disc was removed lateral
to the axilla in several pieces and one big
piece, after what the root became lax. Left
sided cleaning L5-S1. Inspection for remnants
showed small pieces at the axilla of bony
fragments, which were removed. Guardix-sol
applied and the ligamentum flavum returned to
its place.
Routine closure of the wound. Smooth
postoperative recovery. The power of both feet became normal.
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Comments
The patient still has
an estimated postoperative recurrence about 7%,
because the disc space is still not shallow.
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 .
