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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17-SEPTEMBER-2013 UMAR SALEH AL-LARDY 42 YEARS HUGE RECURRENT
PLD L4-5 WITH RIGHT UPWARD MIGRATION.
Anamnesis
The patient was operated by me
11-April-2013 for
bilateral sciatica more the left. Discectomy
L4-5 was done with bilateral cleaning. The
patient was doing well, until 1 month ago got
exacerbation of LBP with right sciatica. The
patient is from Yemen and came 16-September-2013
with bad quality MRI showing huge recurrence of
L4-5 with right upward migration. New MRI of the
lumbar spine repeated 16-September-2013
confirming the previous data.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS was 70
degrees with pain right side. There is profound
weak dorsiflexion right foot -3/5 with
hypalgesia right L5 root territory.
The right upper corner of partially
laminectomized L4 was refreshed and neurolysis
of right L5 root was achieved. The right upward
migrating extrusion was removed in several
pieces. Right sided intradiscal cleaning L4-5
disc space.
Smooth postoperative
recovery. The power of the right foot became normal.
Comments
The patient has still has an estimated
postoperative recurrence around 7% because the
disc space height still not shallow.
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