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
29-MAY-2008 ALI ISSA AL-HARITHY 47 YEARS
EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Anamnesis:
The patient came to the
emergency of Al-Shmaisani hospital 28-May-2008 complaining of LBP with left
sciatica for 8 years. Exacerbation of sciatica
the last 3 days with limping and difficult
walking and positive cough sign.
MRI lumbar spine performed
28-May-2008 showed extruded disc L4-5 with
left downward migration.
On examination: the patient
in agonizing pain with exaggerated scoliotic
stance. SLRS was 25 degrees in the left with
pain. There was weak dorsi and planterflexion left foot
3/5.
Left L4-5 hemiflavotomy with
foraminotomy of left L5 root was performed. The
extruded disc was removed lateral to the axilla.
Meticulous cleaning of the disc space from the
left side. Inspection under the axilla and the
foramen for remnants.
The epidural fat was kept
untouched through the operation.
Routine closure of the wound
with prompt recovery of the power of left foot.
Comments
The recurrence rate is below
7% in this case, because the disc space was
shallow and the defect in the annulus fibrosis
is minimal.
Preserving the epidural fat
minimize the incidence of postoperative
fibrosis.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
