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.fr
07-AUGUST-2008 FARIS ISMAT RASHEED HAUBSH 36 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
clinic 05-August-2008 complaining of LBP and right
sciatica for one month. The patient suffered RTA
in Naltshick 15 years ago with fracture of the
pelvis.
MRI done 07-June-2008 showed
huge extrusion of L5-S1 with right sided
extrusion with downward migration.
On examination: the patient
has exaggerated scoliotic stance, limping with
SLRS 80 degrees with pain in the right. There is
weak dorsiflexion right foot 4/5 and mild weak
planterflexion.
Right L5-S1 hemiflavotomy and
right S1 root foraminotomy was performed. The
extruded disc was removed lateral to the axilla
in several pieces. The disc space was shallow
and small amount came out despite meticulous
cleaning, trying during that not to enlarge the
defect in the annulus fibrosis.
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the right foot.
Comments
The estimated recurrence rate
in this case is minimal, because the disc space
is very shallow and the intradiscal material is
small in amount.
The epidural fat was missing
at the root and compressed parts of the dural
sleeve. Some attempt was paid to transfer the
epidural fat without causing further damage to
this tiny delicate tissue, to lower the
incidence of postoperative scar formation.
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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 .
