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

The patient a known hypertensive, rheumatoid and diabetic patient was operated by me 08-December-2003 for CCS C3-4-5-6 levels with fusion. The patient got CVA 03.November. MRI brain done showing old infarction right parietal lobe. The patient came to the clinic complaining of inability to walk more than 20 meters with intermittent claudication. On examination she had weak dorsi and planterflexion both feet with moderated osteoarthritis right knee and diabetic neuropathy with hypalgesia of both feet up to the dorsum of the feet.. MRI of the lumbar spine showed LCS L3-4 and L4-5 with old fracture of the D12 body without compression . After cardiac consultation, the patient was operated for the LCS. Laminectomy L4 and partially of L3 and upper edge of L5 was performed. Using the high speed drill the medial aspect of the kissing facets of L3-4 and L4-5 were drilled abut to the hypertrophied ligamentum flavum. All the compressive elements were removed and foraminotomy of both L4 and L5 roots was achieved. The dura was very thin at certain areas. Check patency of the foramina was performed.