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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

 

 

24-AUGUST-2008  AHMAD SALEH ASHAAB  75 YEARS  LUMBAR CANAL STENOSIS L3-4 WITH RESIDUAL AFTER DISCECTOMY L4-5 AND L5-S1 PERFORMED 4 YEARS AGO.

Anamnesis:

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The patient came to the clinic 11-August-2008 complaining of LBP with bilateral sciatica which continued after performed surgery for PLD L4-5 and L5-S1 4-5 years ago elsewhere.

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The patient limping with exaggerated scoliotic stance with intermittent claudication and can walk less than 500 meters. There is weak dorsiflexion both feet 4/5.

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MRI performed 16-August-2008 showed lumbar canal stenosis of L3-4 above the performed surgery

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Decompressive Laminectomy of L3 and removal of the remnants of L4. There was no epidural fat. All the compressive elements were drilled out and bilateral L4 foraminotomy was performed to be sure that no compressing elements were left behind. Check of the disc was confirming the absence of extrusion. The soft scar below the surgery level was left in place.

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Routine closure of the wound and smooth postoperative recovery.

Comments

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The patient has lumbar canal stenosis, which is a progressive one. Surgery is the only solution in such a case.

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There are no data about the first surgery and explanation, why the patient continued to complain of the same problems, which was not resolved during the first surgery.

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