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-JUNE-2009 LAFI MUSA SALEH 70 YEARS LUMBAR
CANAL STENOSIS L2-3, L3-4 AND L4-5 WITH DROP FEET
Anamnesis:
The patient came to the
clinic 25-April-2009 complaining of difficult
walking due to severe weak distal muscles lower
limbs. He is a known diabetic, insulin-dependant
for 10 years and he performed decompressive
laminectomy cervical region three years ago
after what the power of the upper limbs
improved.
On examination: the patient
was limping , using crutches with drop both feet
and severe weak planterflexion both feet 2/5
more the right side. He has analgesia below the
knee level both sides.
MRI lumbar spine performed
26-April-2009 showing severe lumbar canal
stenosis L2-3, L3-4 and L4-5 with foraminal
stenosis.
Decompressive laminectomy of L2-5 was performed. Bilateral foraminotomy
of L2,3,4 and L5 roots was achieved both sides.
The epidural fat was absent at all levels and
the dura was transparent, that the running roots
were seen pulsating inside it. Routine
closure of the wound
Smooth postoperative recovery
with the same neurological picture.
Comments
The patient has diabetic
neuropathy which is mostly not related with the
stenosis. It will not improve after surgery.
The patient came with
neglected neurological deficit, which will need
a long time to recover partially.
The aim of surgery is to
prevent further deterioration of his
neurological losses.
Please! wait for 3-5 min till the
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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 .
