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
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03-OCTOBER-2008 AHMAD ODEH AL-LAWI 75 YEARS DE
NOVO POSTTRAUMATIC HUGE EXTRUDED DISC L2-3 MORE TO THE RIGHT . CONDITION AFTER
DECOMPRESSIVE LAMINECTOMY FOR LCS L3-4, L4-5 2 MONTHS AGO.
Anamnesis:
The patient came to the
emergency of Al-Shmaisani hospital
03-October-2008 complaining of bilateral
sciatica with inability to walk for 8 days.
The patient was operated by
me 21-August-2008
for LCS L3-4 and L4-5.
MRI performed today showing a
huge de novo extruded disc L2-3 more to the
right.
On examination: the patient
in agonizing pain and has weak both quadriceps
muscles 4/5 and weak dorsiflexion both feet 3/4
and abduction of the knees 4/5. SLRS was 90
degrees both sides.
During dissection of the
spinous process, it came obvious, that there is
fracture of the spinous process and the right
medial part of the L2-3 facet, which were
subsequently removed.
The right L3 root was
identified and the huge extruded disc L2-3 was
removed intentionally in several pieces, so as
to prevent dural damage.
Meticulous cleaning of disc
space of L2-3 was performed from the right.
Routine closure of the wound.
The power of both legs improved more in the
right side.
Comments
The patient underwent
decompressive laminectomy of L3-4 and partially
of L2 and L5 2 months ago.
The patient and the family
were interrogated after surgery and they told us
that the patient felt twice, after what he got
this complication.
There is no connection
between the two events, and by no means the
second surgery has relation with first.
The estimated recurrence in
this case is below average, because the disc
height is shallow.
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