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
19-OCTOBER-2008 ZAYNAB DAWOOD HAMMAD 62 YEARS
SEVERE LUMBAR CANAL STENOSIS L4-5 WITH DROP RIGHT FOOT.
Anamnesis:
The patient came to the
clinic 15-October-2008 complaining of LBP for 4
years with exacerbation the last 2 months with
numbness of both feet. She could walk only 100
meters with difficulty.
MRI of lumbar spine performed
27-August-2008 showed severe lumbar canal
stenosis L4-5.
On examination: the patient
is limping with exaggerated scoliotic stance and
she had weak
dorsiflexion right foot 1/5 and left foot
-3/5 with SLRS
was 85 degrees in both sides. She had also
severe OA. both knees.
Decompressive laminectomy of
L4 and partial of the upper of L5 and lower of
the L3 lamina was performed. The hypertrophied
ligamentum flavum was removed and foraminotomy
of both L5 roots was achieved. The right L5 root
was severely compressed. Inspection of the
annulus fibrosis of the L4-5 disc confirmed no
extrusion and it was left untouched.
Routine closure of the wound.
The power of the left foot normalized
immediately after surgery and the power of the
planterflexion right foot normalized, but the
power of dorsiflexion improved to 4/5.
Comments
The patient has protracted period
of suffering, for what delayed recovery of the
right drop foot will take place
after surgery.
The surgery must be performed
earlier, but the patient was pushed for surgery
by pain.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
