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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.tv

 

 

03-DECEMBER-2006  FAYEZ SAEED MOUSA  63 YEARS  SEVERE LUMBAR CANAL STENOSIS L1-2, L2-3, L3-4, L4-5 WITH BILATERAL LATERAL RECESS SYNDROME.

The patient came to the clinic 18-March-2006  complaining of left sciatica for 45 days with positive cough sign. The patient is a known diabetic  and cath cardiac vessels done 17-August-2005. The patient have urgency and frequency the last 3 months. On examination that time, the patient had hypalgesia left lower limb above the knee with weak dorsi and planterflexion both feet. MRI performed 28-October-2005 showed extruded disc L1-2 with bulge L4-5 and L5-S1.  The patient was sent for another MRI and given medication.

The patient came 01-May-2006  with new MRI performed 30April-2006 demonstrating severe lumbar canal stenosis  from L1-2 down to L4-5. The patient condition continued to deteriorate and intermittent claudication with inability to walk more than 100 meters.

Decompressive laminectomy of L2-3-4 and partial of L1 and L5 was performed and foraminotomy for L2-3-4-5 roots was performed from both sides. Smooth postoperative recovery.

Comments:

1.  LCS is a progressive disease and when the patient start to have progressive neurologic deterioration, surgery must be performed to prevent further deterioration.

2.  he clinical course of the patient was changing over time and the surgical decisions also.  At the beginning, he was in need for discectomy of L1-2, but later he required surgery for lumbar canal stenosis.

 

 


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