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The group in action.

 
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

 
The patient came to the clinic 18-June-2006 complaining of LBP for 4 months with left sciatica. MRI lumbar spine performed 12-June-2006 showed huge extruded disc L5-S1 with left downward migration. On examination: SLRS was 75 degrees in the left with hypalgesia left L5 and S1 territories with weak dorsi and planterflexion left foot. The patient was given pain-killers and advised for surgery.

The patient during the early morning was urging for surgery, for what, she was admitted urgently and operated. Left L5-S1 hemiflavotomy was performed and the extrusion was removed from under the axilla. Meticulous cleaning of the disc space was achieved from the point of extrusion. The left S1 root was shifted lateral and all compressive elements were removed after what the root became relax and foraminotomy of left S1 root was performed and check of the canal was done.

Smooth postoperative recovery.

Comments:

1. The rule of removal of the extrusion and minimal cleaning of the disc space is not possible all the time. In this case, it was necessary to perform meticulous cleaning, because the defect in the annulus fibrosis was big and it was logical to remove as much as possible to decrease the recurrence rate.

2. Good inspection of all concerned roots in the territory must be performed. The left S1 root was at the start of the operation was hidden lateral to the extrusion. It was identified and decompressed after removal of the extrusion.


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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved