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
22-DECEMBER-2009 ALLA MUHAMED AHMAD 28 YEARS
EXTRUDED DISC L4-5 WITH LEFT FORAMINAL OCCLUSION.
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Anamnesis:
The patient
came to the clinic 02-August-2009 complaining of
LBP with left sciatica for 2 weeks. MRI lumbar
spine performed 30-July-2009 showing old bulge
disc at L2-3, 3-4 and L4-5 with left downward
migration. The patient had no limping, with mild
scoliotic stance with weak dorsiflexion left
foot 4/5. He was advised to continue in
conservative treatment and he improved over the
next several days.
The patient then came to the
clinic 06-December-2009 complaining of
exacerbation of LBP with increased left
sciatica the last 2 weeks with the weakness of
the left foot dorsiflexion -4/5 and right foot
4/5.
Repeat MRI of the lumbar spine performed
09-December-2009 showing increase of the
extrusion of L4-5 with foraminal occlusion.
Left L5 foraminotomy with
partial hemiflavotomy L4-5 was performed from
the left side. The extruded disc of L4-5 was
removed after what the root became lax and free
of compression. Further cleaning of the disc
space was performed lateral to the axilla.
Routine closure of the wound.
The power of the both feet normalized.
Comments
The patient is a young chap
with still having a high disc space with wide
defect in the annulus fibrosis. Logically the
estimated recurrence rate is ranking around 15%.
It was suggested to the patient to include PEEK
Satellite sphere in his surgery, but he refused.
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 .
