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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29-SEPTEMBER-2013 NESRIN HUSNI HASAN 37 YEARS EXTRUDED CENTRAL
DISC L4-5 MORE TO THE RIGHT.
Anamnesis
The patient came to the clinic 23-September-2013
complaining of LBP for 10 years with bilateral sciatica
more to the right. Exacerbation of LBP with
right sciatica last month. Felt down twice
during this time.
MRI lumbar spine done 03-September-2013 showing
huge extruded disc L4-5 central more to the
right.
On examination: the patient is limping with
scoliotic stance. SLRS was 20 degrees with pain
in the right and 0 degree with pain in the left.
She has weak dorsiflexion both feet
-4/5 and planterflexion right foot 4/5. She has
hypalgesia both right L5 and S1 and left L5
territories.
Using C-arm, the L4-5 level was identified.
Laminectomy L4 and upper third of L5. L3-4
flavotomy was done to prevent future escalation
of L3-4 stenosis. Foraminotomy both L5 roots.
The calcified huge extruded disc L4-5 was
attacked from the right side, then from the left
side. Bilateral cleaning L4-5 disc space.
Smooth postoperative
recovery. The power of both feet became
normal.
Comments
The patient still have an estimated
postoperative recurrence around 7%, because the
disc space height is still not shallow even
bilateral cleaning performed.
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