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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

 

 

28-JUNE-2008  FIKRIEY SUBHI AL-QUDSY  63 YEARS  WIDE BASED EXTRUDED DISC L4-5 MORE TO THE RIGHT.

Anamnesis:

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The patient came to the clinic 22-June-2008 with LBP and right sciatica for 1 year with progressive course. The patient has arterial hypertension for 15 years.

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MRI of the lumbar spine done 17-May-2008 showing wide-based extruded disc L4-5 more to the right with foraminal occlusion.

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On examination: the patient is limping with scoliotic stance and dragging her right foot. SLRS was 30 degrees in the right with pain. She had weak dorsi and planterflexion right foot 3/5, and the left foot dorsiflexion 4/5. She had also OA both knees.

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Bilateral foraminotomy of both L5 roots was performed and wide flavotomy was done. The disc extrusion was removed from the right lateral to the axilla, then bilateral cleaning of the disc space of L4-5 was done.  Routine closure of the wound.

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Smooth postoperative recovery and the power of both lower limbs improved.

Comments

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The patient had extruded disc of L4-5 which was not responding to conservative measures. It was decided to perform bilateral cleaning of the disc space, taking into consideration the wide base extrusion.

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The estimated recurrence rate is below average, since the disc space is shallow and bilateral cleaning was performed.

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