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
23-FEBRUARY-2010 ROLLA JERYES HADDADIN 37 YEARS
HUGE EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL AND RIGHT DOWNWARD MIGRATION.
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Anamnesis
The
patient came to the clinic 21-February-2010
complaining of LBP for 15 years of intermittent
course. 25-January-2010 got severe right
sciatica with exacerbation of LBP and numbness
lateral aspect of the right foot.
MRI of the lumbar
spine performed 13-February-2010 showing
extruded disc L5-S1 with right lateral and
downward migration.
On examination: the patient
is limping with exaggerated scoliotic
stance. SLRS was 30 degrees with pain in the
right. Hypalgesia right L5 and S1 roots. There
weak planterflexion 2/5 and dorsiflexion 3/5 of
the right foot.
Foraminotomy of right S1 root
was achieved and the extruded disc with downward
migration was removed in several pieces. Upward
inspection revealed another extrusion at the
disc space of L5-S1 level, which was also
removed and right sided cleaning of the shallow
disc space was performed. It was possible to see
the right L5 root and the right S1 root was free
for 12 mm down of the axilla . The root was
swollen.
Routine closure of the wound.
Smooth postoperative
recovery, and the power of the right foot
improved.
Comments
The disc space was
shallow, for what the estimated recurrence rate
is low and there is no need for insertion of the
Satellite PEEK sphere.
The swollen root was
inspected carefully to avoid missing intradural
penetration of disc fragments.
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 .
