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-2010 MUNIRA ABDEL-RAHIM ABU-SAFIYEH 53
YEARS EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
connection.
Anamnesis
The
patient came
to the clinic 07-August-2010 complaining of LBP
for 17 years with right sciatica. The patient
has lymphoedma of the left lower limb for 18
years. MRI performed 05-August-2010 showing
extruded disc L5-S1 with right downward
migration with bulge L4-5. In comparison to the
MRI performed 10-May-2005 the extruded disc
became bigger in size.
On examination: the
patient is limping with exaggerated scoliotic
stance . SLRS was70 degrees in the
right with pain with almost drop right foot 3/5
and weak planterflexion 4/5.
Right sided L5-S1
hemiflavotomy with foraminotomy of right S1
root. The root was severely compressed
laterally. The extruded disc was bony hard and
it was necessary to drill it from under the
axilla. After removing the subaxillary part and
cleaning of the L5-S1 disc space, it became
possible to retract the root medially and
drilling of the lateral part of the extrusion
was performed. Further cleaning of the
intradiscal space was achieved. The root became
relax and free of any compression.
Routine closure of
the wound and smooth postoperative recovery with
improvement of the power of the right foot and
disappearance of right sciatica.
Comments
The estimated postoperative
recurrence rate in this case is minimal
because the disc space height is very shallow.
The extruded disc was bony
hard and neglected for long time and it was bony
hard. It was necessary to remove it using
high-speed drill.
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 .
