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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06-JANUARY-2012 BILAL IBRAHEEM ABU-AFIFAH 36 YEARS
EXTRUDED DISC L3-4 WITH SEGMENTAL STENOSIS.
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
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.
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.
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.
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
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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
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 .