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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15-JULY-2009 SUAAD HASAN RADWAN 53 YEARS HUGE
EXTRUDED DISC L3-4 WITH UPWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 13-July-2009 complaining of LBP and left
sciatica for 10 days with numbness of the left
knee region. The patient was operated by me 2001
for PLD L4-5 left side.
On examination: the
patient is limping with
scoliotic stance and
weak dorsiflexion left
foot 3/5 with hypalgesia
of left L4 territory.
The patient was sent to
perform MRI lumbar
spine, which confirmed
the presence of very
huge extruded disc more
in the right at the disc
level and left side in
the upper migrating
direction.
Bilateral flavotomy of
L3-4 with
image-intensifier guide.
Both sides of the dural
sleeve was exposed. It
was possible to remove
the extruded disc in one
piece from the right at
the disc level.
Inspection of the other
side for remnant was
negative. The
defect in the annulus
fibrosis was pin-point.
Considering that the
disc height was shallow
and the extrusion was
very big, it was decided
not to violate the disc
space.
Smooth postoperative recovery
with improvement of the power of the left foot.
Comments
The expected recurrence rate
in this case is minimal, for what even the disc
space was not violated.
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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 .
