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
08-MARCH-2010 BADIAA AHMAD AREF JACOB 53 YEARS
HUGE EXTRUDED DISC L3-4 CENTRAL WITH SLIGHT UPWARD MIGRATION.
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Anamnesis
The
patient came to the clinic 02-March-2010
complaining of LBP for 3 years with left
sciatica for 7 months. Exacerbation last 2 weeks
with agonizing pain reaching the left L5 root
territory. Yesterday she was unable to walk.
On examination: the
patient with help is limping with exaggerated
scoliotic stance. SLRS was 5 degrees in the
right and 20 degrees in left. There is weak
planterflexion right foot -4/5 and dorsiflexion
same foot 4/5.
MRI lumbar spine
done 05-March-2010 showing huge central
extrusion L3-4 with slight upward migration.
Using image-intensifier, the
L3-4 level was identified and bilateral
flavotomy L3-4 was done. Attempt to remove the
extrusion from the right failed. The fragment
was captured from the left, from where it was
originating and it was removed in one piece.
Bilateral cleaning L3-4 from both sides.
Routine closure of the wound.
Smooth postoperative
recovery, and the power of right foot became
normal.
Comments
Despite the fact that most of
the disc was pushed to the right, but capturing
it from the right was unsuccessful. Capturing it
from the left from where it was originating was
possible, and the centrally extruded disc was
removed in one piece.
Bilateral cleaning could
decrease the postoperative recurrence rate.
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 .
