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Dr. Ali Al-Bayyati and Dr. Munir Elias

 
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

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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.

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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.

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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.

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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.

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Routine closure of the wounds. Smooth postoperative recovery with improvement of the power of the left foot.


 

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Comments

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The patient still having recurrence rate around 7% because the disc space is not shallow.

 


Back Up!

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 .

 

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