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
27-FEBRUARY-2010 WAFA AHMAD SHAHEEN 51 YEARS
EXTRUDED DISC L4-5 WITH LEFT FORAMINAL OCCLUSION.
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 17-February-2010
complaining of exacerbation of left sciatica the
last week. She was not limping but she had
scoliotic stance as in 05-May-2008. There
was weak dorsiflexion left foot -4/5 with
numbness of the 2 and 3 toes left foot.
The patient was
operated by me 25-September-2002 for PLD L5-S1
for right sciatica.
MRI of the lumbar
spine performed 20-February-2010 showing
extruded disc L4-5 with left foraminal
occlusion, more than the extrusion seen in the
MRI performed 06-May-2008.
Left L4-5 hemiflavotomy and
foraminotomy of left L5 root was performed. The
left L5 root was severely compressed but the
extrusion and the dural wall was very thin and
transparent. The extruded disc was removed
lateral to the axilla and left sided cleaning of
L4-5 was done. There is a small tear of the root
due to compression, but without CSF leak, for
what application of bipolar coagulation could
eliminate the tear without applying repair.
Routine closure of the wound.
Smooth postoperative
recovery, and the power of the left 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 root was
tiny small and the dural wall was transparent
due to old compression.
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 .
