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-2003 RABIHA MUHAMED SAEED 65 YEARS
SEGMENTAL STENOSIS L4-5 WITH EXTRUDED DISC MORE TO THE LEFT.
Anamnesis
The patient came to the clinic 19-February-2003
telling that she has LBP since 1988with right
sciatica with intermittent course. The last 3
days she got severe LBP with left sciatica down
to the big toe with positive cough sign.
The patient is a known hypertensive for 3 years
and cath was done three times.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS was
10 degrees with pain left side. She has weak
dorsi and planterflexion both left foot 3/5.
There is hypalgesia left L5 and S1 territories.
Decompressive laminectomy
L4-5 with foraminotomy both L5 roots. Left sided
removal of the extrusion and cleaning of the
disc space of L4-5. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. Routine closure of
the wound.
Follow Up
The patient came to the clinic 10-March-2003 with
clean wound with SLRS 85 degrees in the left
with less pain and normal power of the feet with
hypalgesia of the left L5 and S1 roots
territories.
Comments
The patient still have an estimated
postoperative recurrence around 7%, because the
disc space is not completely shallow.
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