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
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04-DECEMBER-2010 USAMA MUSA RAJA 40 YEARS
RECURRENT PLD L4-5 RIGHT SIDE.
came to the clinic 22-November-2010 complaining
of right sciatica down to the ankle for two month. The patient was operated by me
1998 for huge PLD L4-5 with right
spine performed 31-October-2010 showing
recurrent PLD L4-5 with right foraminal
examination: The patient is in
pain, limping with exaggerated
scoliotic stance. There is weak dorsi and
planterflexion right foot
4/5 with SLRS 80 degrees with pain in the right.
Using image-intensifier, foraminotomy of right
L1 root was performed. The extruded disc was
attacked lateral to the axilla and it was
removed in several pieces, after what the root
became lax. Meticulous cleaning of the disc
space of L4-5 was achieved from the right.
closure of the wound. Smooth postoperative
recovery and improvement of the power of right
The patient has persistent
recurrent extrusion with dark gray extrusion of L4-5
level, which will
not resolve over the time. Surgical
decompression is the only solution.
Usually the recurrence take
place at the same side of previous extrusion.
The estimated recurrence rate
is still around 7% because the disc space is
not shallow, despite the fact meticulous cleaning was
performed from one side twice.
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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 .