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-NOVEMBER-2012 SAMI HANI HARB 65 YEARS LCS
L3-4, L4-5 WITH EXTRUDED DISC L4-5 LEFT SIDE.
Anamnesis
The patient came to the clinic 22-September-2012
complaining of LBP and left sciatica for 17 days
with numbness all toes left foot and positive
cough sign. The patient is known diabetic for 12
years with arterial hypertension. He is allergic
to Voltaren.
MRI of the lumbar spine done 06-September-2012
showing minimal LCS L3-4, and severe LCS L4-5
with extrusion of the L4-5 left side causing
left foraminal occlusion with bulge L5-S1.
On examination: the patient is limping with
minimal scoliotic stance. SLRS 25 degrees in
the left
with pain. There is
weak dorsiflexion left foot 3/5 and hypalgesia
left L5 and S1 territories.
Laminectomy of L4 with upper
part of L5 and foraminotomy left L5 root. There
was severe stenosis at L4-5. Flavotomy L3-4 was
done. The extruded disc L4-5 was removed lateral
to the left L5 axilla. Meticulous cleaning of
L4-5 disc space was achieved.
Routine closure of the wounds. Smooth
postoperative recovery. The power of the left
foot
became normal.
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Comments
The patient still has an
estimated postoperative recurrence around 7%,
because the disc space is still not shallow.
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