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
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21-MARCH-2009 RUBA RUSHDY AL-DILI 39 YEARS
HUGE PLD L4-5 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 01-February-2009 complaining of right
sciatica for 10 months.
MRI lumbar spine performed
02.April-2008 showed huge extruded disc L4-5
with right extrusion.
On examination the patient
was limping with exaggerated scoliotic stance
with SLRS 30 degree in the right and weak
dorsiflexion right foot 3/5 and planterflexion
4/5 respectively.
MRI investigation was
repeated 07-February-2009 showing the same
extrusion.
Right L5 root foraminotomy
was performed and the extruded disc was removed
lateral to the axilla. Right sided cleaning of
L4-5 disc space was performed. The defect in the
annulus fibrosis was medium in dimensions.
There was tiny dural defect
at the lower edge of the exposed dura, which was
closed by nylon 6 zero and check for CSF leak
was tested and it was negative. Routine closure
of the wound
Smooth postoperative
recovery with normalization of the power of the
right foot.
Comments
The patient has slightly
shallow disc space of L4-5 and the defect of the
annulus fibrosis is medium in size, for what the
expected recurrence rate in this case is below
7%.
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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 .
