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Munir Elias 20-12-2013

 
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

 

The patient  came to the clinic with agonizing pain with left sciatica and severe weak dorsi and planterflexion of the left foot with SLRS right 10 degrees. She was sent for MRI lumbar spine, confirming the presence of huge prolapsed disc L5-S1 left side. She had LBP for 3 years, but the severe sciatica for 7 days.

The patient was operated: Left L5-S1 hemiflavotomy was done with foraminotomy of left S1 root. The huge extrusion was removed in one piece from under the axilla, after what the root became relaxed and free. The root shifted medially and the disc wall was inspected and it was glistening and no compression was seen. Considering the huge extrusion and the absence of compression from the disc wall, the disc space was not violated.

Comments:

1. The main attention for this policy is to monitor the rate of recurrence. It is early to predict the long-run outcome of this policy, but it merits outweighing its cons.

 


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