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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18-FEBRUARY-2013 SAMI ABDEL-AZZIZ AL-KOOZ 38 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 16-February-2013 complaining of
LBP and right sciatica for 2 years with
exacerbation the last 10 days with numb and pain
right foot.
On examination: The patient is limping with
exaggerated scoliotic stance. SLRS was 20 degrees
with pain in the right and 45 degrees in the
left shooting to the right leg. There is
weak dorsiflexion and
planterflexion right foot 3/5 with hypalgesia
right S1 territory. The bladder if
full and cannot void for what Foley's catheter
was inserted.
MRI lumbar spine done 03-February-2013 showing
huge extruded disc L5-S1 with right downward
migration and small bulge L4-5.
Right S1 foraminotomy. The
extruded disc was found lateral to the axilla.
It was removed in one piece. Right sided
intradiscal cleaning L5-S1. The root became lax
and free.
Routine closure of the wound.
Smooth postoperative recovery. The power of
right foot became normal.
Comments
The patient had huge extrusion of L5-S1 without
improvement. Surgical intervention is the only
solution.
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still not shallow.
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