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.tv

A 56 year age lady came with intermittent claudication both leg for not less than 6 years to the clinic 2 weeks ago. The patient was operated for unknown reasons for her left knee without benefit. The condition deteriorated and  bilateral sciatica took place after she felt down to the buttocks  one and half month ago. MRI investigation showed severe lumbar canal stenosis at L4-5 with kissing facets. On examination LBP was minimal and severe weak dorsi and planterflexion of all toes both feet were evident  and the patient was able to walk only with aid. The patient was operated and decompressive laminectomy L4 was achieved and bilateral flavotomy L3-4 and L4-5 was performed with bilateral L5 forminotomy. Inspection of the L4-5 disc showed no necessity to violate it. But mild instability of L4-5 facets was noted, which was left without interference.