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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20-JULY-2009 ROLLA ABDEL-FATAH AL-HMOUD 37 YEARS
EXTRUDED DISC L4-5 WITH RIGHT FORAMINAL OCCLUSION -PREGNANT 6 MONTHS.
Anamnesis:
The husband of the patient came to the
clinic 18-July-2009 telling that his wife cannot
come to the clinic due to agonizing right
sciatica and that she is pregnant with 5-6
months. The sciatica is for one month duration.
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.
MRI lumbar
spine performed 14-July-2009
showing
huge extruded disc
L4-5
with right downward migration.
Right hemiflavotomy of
L54-5 and foraminotomy
of right L5 root was
performed and removal of
the extrusion was
achieved lateral to the
axilla and meticulous
cleaning of L4-5 disc
space was performed from
the right.
Considering the age of
the patient and still
not shallow disc space
height, the Satellite
PEEK nucleus replacement
sphere was suggested to
the patient, but the
husband ignored the
idea.
Routine closure of the
wound.
Smooth postoperative recovery
with improvement of the power of the right foot.
Comments
The expected recurrence in
this case is above 7% and insertion of the
replacement nucleus was an ideal solution to
decrease this figure, but the patient refused to
perform such procedure.
Premature labor could happen
even without surgical intervention, for what a
consensus was explained to the father before
surgery about this event in case that it took
place during the stay in the hospital.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
