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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06-FEBRUARY-2012 WALEED SALMAN ALBAIENY 46 YEARS
EXTRUDED DISC L4-5 WITH RECENT RIGHT FORAMINAL AND OLD LEFT FORAMINAL OCCLUSION.
Anamnesis
The
patient came to the clinic
29-January-2012 complaining of LBP for 5 years
with left sciatica, which improved with
subsequent deterioration the last 4 days and
right sciatica down to the soleus muscle.
On
examination, the patient is limping with
scoliotic stance. SLRS was 30 degrees with pain
in the right and 60 degrees with less pain in
the left. There is weak dorsiflexion right foot
-4/5.
MRI of the
lumbar spine was performed 30-January-2012
showing extruded disc L4-5 with right fresh
foraminal occlusion and old left foraminal
occlusion.
Bilateral flavotomy L4-5.
Foraminotomy both L5 roots. The extruded disc
was removed first from the left side, then from
the right side. Bilateral cleaning L4-5 disc
space. The epidural fat was missing in most of
the exposed area. After removal of the extrusion
the roots became lax.
Routine
closure of the wounds. Smooth postoperative
recovery with normalization of the power of the
right foot.
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Comments
The patient has 2 events at the same
level, one old and another is recent. The old now is not
complaining about, but the recent causing agonizing pain
with weakness.
Usually the old disc is looking dark and
hard in consistency and the fresh one looking gray-white and
soft. Here the data were the opposite.
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 .
