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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16-JULY-2009 NIDA YASEEN HASAN 28 YEARS VERY
HUGE EXTRUDED DISC L5-S1 WITH RIGHT INFERIOR MIGRATION POSTERIOR TO THE DURAL
SAC.
Anamnesis:
The patient came to the
clinic 12-July-2009 complaining of LBP and right
sciatica for 1 week with numbness of the right
foot.
On examination: the
patient is limping with
scoliotic stance, SLRS
was 30 degrees in the
right with pain and
weak dorsi and
planterflexion right
foot 3/5 with hypalgesia
of right L5 and S1 territories.
The patient was sent to
perform MRI lumbar
spine, which confirmed
the presence of very
huge extruded disc
L5-S1more in the right
with downward migration
posterior to the dural
sac.
Bilateral flavotomy of
L5-S1. Both sides of the
dural sleeve was
exposed. The disc
material was covering
the dura and it was
adherent to it. It was
necessary to sharp
dissect the disc
material of the thin
dura and it was removed
in several pieces from
the right side.
Right sided cleaning of
the disc space.
Considering the age of
the patient and still
not shallow disc space
height, the Satellite
PEEK nucleus replacement
No 11 was inserted from
the right side and
checked with
image-intensifier.
Routine closure of the
wound.
Smooth postoperative recovery
with improvement of the power of the right foot.
Comments
This is the first time over
30 years period I see such a big extrusion which
cover the dura and it was necessary to dissect
it shapely to remove it and proceed with further
removal of the extrusion.
Considering the young age and
still not shallow disc space of L5-S1 it was
preferable to insert the satellite nucleus
replacement to decrease the rate of
recurrence and preserve some functionality to
this segment of the spine.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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