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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16-JULY-2013 TALAL FEHMY AL-NAJJAR 39 YEARS EXTRUDED DISC L4-5
CENTRAL MORE TO THE LEFT.
Anamnesis
The patient came to the clinic 15-July-2013
complaining of left
sciatica sciatica for 30 days. Exacerbation lat
2 weeks the agonizing sciatica the last day with
numbness of both feet, more the left foot.
MRI lumbar done 14-July-2013 showing huge
extruded disc L4-5 central more to the left. MRI
brain performed normal, cervical bulge C4-5.
On examination: the patient is limping with scoliotic stance with SLRS
7
degrees with pain in the right and 5 degrees in
the left. Weak
dorsiflexion left foot 3/5 and 4/5 right foot. There is
analgesia left left
L5 root and hypalgesia right side.
Left L4-5 hemiflavotomy. Left
L5 root foraminotomy. The huge centrally
extruded disc was approached lateral to the
axilla. It was removed in several pieces. Left
sided intradiscal cleaning L4-5 disc space.
Inspection of the root down the disc level
revealed huge piece, which was removed in one
big piece.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
feet became normal with regression of the
left sciatica.
Comments
The patient still has an estimated postoperative
recurrence around 7%, because the disc space is
still not completely shallow.
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