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
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23-SEPTEMBER-2008 SUHAILA SALEM AL-KHATEEB 46
YEARS HUGE EXTRUDED DISC L4-5 CENTRAL MORE TO THE LEFT.
Anamnesis:
The patient came to the
clinic 11-September-2008 complaining of LBP for
15 years with left sciatica. Exacerbation the
last two weeks of the left sciatica.
The patient was treated for
Ca breast 5 years ago.
On examination: the patient
in agonizing pain. Limping with scoliotic stance
with pain left side. She had almost drop
left foot and
weak planterflexion left foot 4/5.
MRI performed
13-September-2008 showed extruded disc of
L4-5 with left downward migration and bulge
L5-S1.
Left hemiflavotomy of L4-5
was done and foraminotomy of left L5 root was
achieved. The extruded with down migrating
piece was removed in several fragments lateral
to the axilla.
Considering that the disc space still high and
the annulus fibrosis is not hard and there is
defect at the annulus, it was decided to
clean the L4-5 disc space meticulously from the
left side.
The defect of the annulus
fibrosis was wide, for what further cleaning was
performed.
Routine closure of the wound
and smooth postoperative recovery.
Comments
The patient had still
not shallow disc space, for what the estimated
recurrence rate could be more than 7%.
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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 .
