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-APRIL-2009 NISREEN ABDEL-HAFETH
AL-NIJDAWI 57 YEARS LUMBAR CANAL STENOSIS L3-4, L4-5
WITH RIGHT LATERAL RECESS SYNDROME.
Anamnesis:
The patient came to the
clinic 06-January-2009 complaining of LBP for
more than 5 years with intermittent claudication
for one year and progressing right sciatica.
On examination: the patient
has SLRS 90 degrees with pain in the right with
weak dorsiflexion both feet more the right -4/5.
MRI lumbar spine performed
10-January-2009 showing lumbar canal stenosis
L3-4 and L4-5 with right lateral recess
syndrome.
Laminectomy of L4 and partial
of L3 and L5 was performed. Foraminotomy of
right L4 and L5 roots was achieved. Inspection
of the L3-4 and L4-5 from the right side ruled
out presence of extrusion, for what they were
left untouched. The epidural fat was absent at
most of the operative field. Check for
instability was negative. Routine closure of the
wound.
Smooth postoperative recovery
and the power of both feet normalized.
Comments
The patient had small tiny
disci for long time, for what surgery was not
advised. When she progressed lumbar canal
stenosis, and since this pathologic entity is a
progressive one, surgery was advised.
It is the sense of the
neurosurgeon when to violate the bulging disc or
not to violate. It is better not to touch the
bulging disc since it could bring the problem of
recurrent disc. Since the roots are free of
compression and there is no signs of
instability, then decompression of all elements
is the best choice in resolving such problem.
Please! wait for 3-5 min till the
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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 .
