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
12-APRIL-2009 RASMIYEH ATIYEH HIJAZY
68 YEARS LCS L3-4, L4-5 AND L5-S1 WITH SPONDYLOLISTHESIS L4-5
AND BILATERAL RECESS SYNDROME L4-5.
Anamnesis:
The patient came to the
clinic 09-April-2009 complaining of LBP for
three years with exacerbation the last year and
bilateral sciatica and inability to walk more
than 150 meter with intermittent claudication.
The patient has frozen left shoulder for more
than 10 years.
MRI lumbar spine performed
07-February-2009 showing spondylolisthesis L4-5
with elements of severe stenosis.
On examination: there is weak
dorsiflexion both feet 3/5 more the right and
planterflexion right foot 4/5 and hypalgesia
right L5 territory.
The patient was sent for MRI
lumbar spine with MR Myelography which was performed
10-April-2009 showing the same findings
including LCS L5-S1 and L3-4 with bilateral
recess syndrome at L4-5. Bone density scan was
normal for the spine and osteoporotic for the
hips.
Decompressive laminectomy of
L3-4-5 was performed and check for instability
was performed at all steps of the operation. It
was negative. Foraminotomy of both L5 roots was
performed. The roots hanging free. Routine
closure of the wound.
Smooth postoperative
recovery with prompt recovery of the power of
both feet.
Comments
During surgical intervention
transpedicular screws were included in the plan
for possible fixation, in case that instability
having place.
At all stages of the surgery,
check for instability was performed and plan to
use transpedicular screws was abandoned at the
end of the procedure.
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 .
