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
The patient a known diabetic came to the clinic
16-April-2006 complaining severe agonizing LBP with bilateral
sciatica with inability to walk with drop left foot. The patient was
sent to perform MRI of the lumbar spine, which proved to have
discitis of L4-5 after 2 surgeries, one performed 2004 and the last
4 weeks ago by other neurosurgeon. The patient was treated by
dalacine-C 300 mg twice daily and pain-killers. The patient then
came 17-July-2006 with the same agonizing pain with drop left
foot and hypalgesia of left L5 territory. The patient was sent
another time for MRI, which showed massive bilateral recurrence of
L4-5 disc.
The patient was operated and foraminotomy of both L5
roots was performed and the dural sleeve was followed superiorly and
the massive extrusion was removed from both side with meticulous
cleaning of the L4-5 disc space. The disc material which was removed
was partially involved in the inflammatory process.
Comments:
1. Vigorous
cleaning and presence of diabetes mellitus with the inflammatory
process are predisposing factors for recurrence.
