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Dr. Ali Al-Bayyati and Dr. Munir Elias

 
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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06-JANUARY-2012  BILAL IBRAHEEM ABU-AFIFAH  36 YEARS  EXTRUDED DISC L3-4 WITH SEGMENTAL STENOSIS.

Anamnesis

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The patient came to the clinic 28-June-2010 complaining of LBP for 5 months with right sciatica not reaching below the right knee. MRI lumbar spine performed 26-June-2010 showing bulge L3-4, L4-5 and L5-S1. The patient was not limping without scoliotic changes and he was neurologically free and was advised to keep in conservative treatment. The patient then came  24-December-2011 complaining of exacerbation of LBP the last 3 months with bilateral sciatica, more in the morning. He was complaining of numbness of the anterior aspect of the right thigh.

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On examination, the patient is now not limping with mild scoliotic stance. There is weak dorsi and planterflexion both feet 4/5 with hypalgesia below both knees. SLRS was 35 degrees in the right with pain and 30 degrees in the left with more pain.

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The patient was sent for MRI of the lumbar spine, which were done 28-December-2011 showing extruded disc L3-4 with secondary segmental stenosis. Dorsal spine MRI showed small PDD D5-6, 6-7 and D7-8.

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Under C-arm the L3-4 level was identified. Wide laminectomy of L3 and partial of L4 was done. The extruded disc of L3-4 was cleaned from both sides. All the stenotic elements were eliminated. There was no epidural fat in the area of exposure.

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Routine closure of the wounds. Smooth postoperative recovery with improvement of the power of the both feet.


 

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

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The patient has still postoperative recurrence rate around 7%, because the disc space is still not shallow, even with meticulous bilateral generous cleaning.

 

 

 


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