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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23-FEBRUARY-2012 QASEM ABBAS NAJEM 37 YEARS
EXTRUDED DISC L3-4 MORE TO THE LEFT WITH CAUDA EQUINA SYNDROME.
Anamnesis
The
patient came to the clinic 19-February-2012
complaining of LBP for 12 years with right
sciatica for 7 years. The last 9 months got
exacerbation of LBP with left sciatica,
exaggerated the last 3 months with micturition
problems.
MRI lumbar
spine performed 18-February-2012 showing huge
extruded disc L3-4 more to the left with bulge
L4-5 and L2-3.
On
examination, the patient is not limping with
exaggerated
scoliosis. SLRS was 70 degrees both sides with
pain. There is hypalgesia below L2 left side
with weak dorsiflexion left foot -4/5.
In prone position, bilateral
extended flavotomy L3-4 after checking the level
with C-arm. The extruded disc was removed from
the left side first, then right sided cleaning
L3-4 disc space was achieved.
Routine
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
left foot.
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Comments
The estimated postoperative recurrence still
ranking around 7% or higher, because the disc
space is still not shallow, despite bilateral
clearance.
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 .
