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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01-JANUARY-2012 YASER MUHDY SALEH 41 YEARS EXTRUDED
DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The
patient came to the clinic 31-December-2011
complaining of LBP for 15 years with left
sciatica for 1 year and exacerbation of the
sciatica the last 4 months with radiation of the
pain to the lateral malleolus.
MRI of the
lumbar spine performed 27-December-2011 showing
huge extruded disc L4-5 with left foraminal
occlusion, the same data which were obtained in
previous MRI done in Baghdad 18-October-2011.
On
examination, the patient is limping with
exaggerated scoliotic stance. There is weak
dorsiflexion left foot 3/5 and planterflexion of
the same foot 4/5. There is hypalgesia below the
left knee with preservation of the left S1
territory. SLRS was 40 degrees in the right with
tightness and 30 degrees in the left with pain.
The left AJ is absent.
Foraminotomy left L5 root
with partial flavotomy L4-5. The extruded disc
was removed lateral to the axilla. The root
regained relax position. There was no epidural
fat at the root area. Left sided cleaning L4-5.
The shifted epidural fat was transferred to the
root area.
Routine
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
left foot.
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Comments
The patient still having recurrence rate around
7% because the disc space is not shallow.
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 .
