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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22-NOVEMBER-2013 NASHAAT MAHMUD MUSA 37 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient came to the clinic 14-May-2013
complaining of LBP with right sciatica for 5
months down to L5 territory.
MRI lumbar spine done 04-May-2013 showing
extruded disc L5-S1 with right S1 root
compression.
On examination is limping with exaggerated
scoliotic stance with positive cough sign. SLRS was
60
degrees right side with pain. There is weak
dorsiflexion right foot 4/5. The patient was
advised to undergo surgery, but he escaped for
financial reasons.
The patient then came 21-November-2013 urging
for surgery. He is in agonizing pain and right
SLRS was 20 degrees with the same weakness with
analgesia of right S1 and hypalgesia of right L5
root.
New MRI done urgently and confirmed the presence
of the same extrusion.
Right S1 foraminotomy with
partial flavotomy. The extruded disc was removed
lateral to the axilla. Right sided intradiscal
cleaning L5-S1 disc space. Routine closure of
the wound.
Smooth postoperative
recovery. The power of the right foot became
normal.
Comments
The patient still has an estimated postoperative
recurrence around 7%, because the disc space is
still not shallow.
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