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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03-AUGUST-2008 RAAD AHMAD AL-ZUUBI 32 YEARS
HUGE RECURRENT PLD L4-5 RIGHT SIDE.
Anamnesis:
The patient came to the
clinic 28-July-2008 complaining of severe severe
LBP with right sciatica, which persist after
performing surgery for PLD L4-5 2 months ago
elsewhere.
On examination: the patient
in agonizing pain with exaggerated scoliotic
stance with SLRS 20 degrees right side and 35
degrees in the left with pain. Hypalgesia below
the right knee with weak dorsiflexion right foot
-4/5.
The patient was sent for new
MRI and lab investigations to rule out discitis.
MRI performed 29-July-2008 showed very huge
recurrence at L4-5 right side.
The right L5 root was
refreshed and lateral to it, the huge extrusion
was removed in one big piece. Meticulous
cleaning of the disc space from the right was
performed.
Routine closure of the wound
with normalization of the power of the right
foot.
Comments
Recurrence in lumbar disc
surgery still consisting a dilemma, which needs
a solution.
During surgery the defect in
the annulus fibrosis was wide, for what the
recurrence took place immediately after the
first surgery.
Meticulous cleaning could
lower the incidence of further recurrence, but
by no means it delete it.
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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 .
