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
11-JUNE-2008 MANAL ABDALLAH SUWWAN 37 YEARS
DE NOVO PLD L3-4 WITH LEFT FAR-LATERAL EXTRUSION, OBLITERATING THE
FORAMEN. RESIDUAL AFTER TWO SURGERIES FOR PLD L4-5.
Anamnesis:
The patient came to the
clinic 07-June-2008 with
sciatica for three weeks more the left. She was
operated 10-May-1997 for PLD L4-5 and
reoperated for recurrence at the same site for
drop foot 29-August-2004 for the same
sciatica.
On examination: the patient
still has weak drop foot , but without sensory
deficit. SLRS was 80 degrees in the left.
MRI lumbar spine performed
04-June-2008 showing de novo PLD L3-4 in the
left side with far-lateral extrusion, occluding
the left L4 root foramen.
Laminectomy L3 and removal of
the remnant of L4 was performed. Foraminotomy of
left L4 root was achieved. The left far-lateral
extrusion was removed and meticulous cleaning of
L3-4 was performed from the left.
Image-intensifier was used to speed the
operative management.
Smooth postoperative recovery
and the power of the left foot still the same.
Comments
The recurrence rate in
this case is below the average, because the
disc space height is minimal.
Recurrent disc leave scar,
for what dissection must be started from the
healthy tissues.
Good imagination of the
extrusion must be kept in mind so as not to miss
the extrusion.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
connection.
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 .
