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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06-JANUARY-2008 MUNA MUHAMED AHMAD DIYAB 40 YEARS PLD
L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 22-December-2008 complaining of LBP for
10 days and left sciatica
MRI lumbar spine performed
20-December-2008 showed a huge PLD L5-S1 with
left downward migration.
On examination: the patient
in agonizing pain with exaggerated scoliotic stance. SLRS
was 70 degrees left side with absent AJ left
side and weak planter and dorsiflexion left foot
-4/5 with numbness left S1 root territory.
Left S1 foraminotomy and left
partial flavotomy of L5-S1 was performed. The
left S1 root swollen and not movable and pushed
posteriorly by the extruded disc. The origin of
the S1 root was high, for what all the maneuvers
were performed subaxillary. The extruded disc
and downward migrating piece was removed in
several pieces, after what the root became free
and movable. Meticulous cleaning of the L5-S1
disc space was performed from the left side. Routine
closure of the wound.
Smooth postoperative recovery
and the weakness of the left foot disappeared after
surgery.
Comments
The patient had anatomical
variation with emergence of the root higher than
usual. The extruded disc was removed from under
the axilla.
The actual recurrence rate
after disc surgery is around 30%, but only 7%
require surgery.
The expected recurrence in
this case ranging around 7%, because the disc space
still not shallow.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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