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
15-JULY-2009 HADIYEH MUHAMMED HARB 61 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL COMPRESSION.
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Anamnesis:
The patient was transferred
from other hospital with clinical signs of
agonizing right sciatica for 4 days. The patient
is a known diabetic.
MRI lumbar spine
performed 13-July-2009
showing extruded disc
L5-S1 with right
foraminal occlusion.
On examination: the
patient is limping with
scoliotic stance and
weak dorsi and
planterflexion right
foot 3/5 with hypalgesia
of the right S1 root.
Right S1 foraminotomy
was performed and the
ligamentum flavum was
reflect to the left.
Removal of the extrusion
lateral to the axilla
and meticulous cleaning
of L5-S1 space from the
right. Considering
that the disc space of
L5-S1 was still high and
the defect in the
annulus fibrosis was
wide, it was mandatory
to insert the Satellite
PEEK nucleus replacement
No 15 after the last
trail of No 14 from the
left side. Check X-ray
showed acceptable
position. The patient
had osteoporosis, for
what so as to prevent
slipping of the device,
it was pushed more
centrally and chips of
bony fragments were
inserted to the right
side of the sphere. The
sphere was not movable
inside the disc space.
Routine closure of the
wound.
Smooth postoperative recovery
with improvement of the power of the right foot.
Comments
The expected recurrence rate
in this case is high, for what the Satellite
PEEK nucleus replacement was applied to prevent
further future collapse and minimize the rate of
postoperative recurrence.
With presence of
osteoporosis, insertion of the trail devices
must be done with care and it is advised to
modify the shape of the squashed trail sphere to
have more tapered angle at the anterior edge to
minimize the traumatic insertion
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 .
