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
14-MAY-2008 HABUBAH IZZIDEEN SHEHADAH 74 YEARS
LCS L2-3, 3-4 AND L4-5 WITH FORAMINAL STENOSIS MORE THE LEFT L5 ROOT TRAJECTORY.
Anamnesis:
The patient came to the
clinic 19-April-2008 complaining of LBP with
left sciatica for one week. She could walk only
100 meters.
MRI performed 07-July-2007
showed lumbar canal stenosis at L3-4 and L4-5.
On examination: the patient
is limping with scoliotic stance. SLRS was 70
degrees with pain in the left side. There was
weak dorsiflexion both feet 4/5 and
planterflexion right foot -4/5 and left foot 4/5
with hypalgesia left L5 territory.
MRI lumbar spine with
MRMyelography done 19-April-2008 showed LCS at
L2-3, 3-4 and L4-5 with left L5 root foraminal
occlusion.
The patient is a known
hypertensive with cardiomyopathy, for what, she
was sent for cardiac consultation prior to
admission.
Decompressive laminectomy
L3-4 and partial of L2 and L5. Foraminotomy of
all running roots was achieved. Special
attention was paid to the left L5 root. It was
compressed by the ligamentous structures of the
left facet joint, fulfilling all the foramen.
Routine closure of the wound
with smooth postoperative recovery.
Considerable improvement of
the power of both feet.
Comments
Lumbar canal stenosis is a
progressive disease and the surgical
intervention is the only solution for the
progressive one. Wide decompression is
recommended to eliminate all the compressive
elements. Otherwise the patient will show
clinical manifestations of the untreated part.
Laminotomies are of no help in these cases and
practice confirm these observations.
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