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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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05-OCTOBER-2011  KAMAL SULAYMAN AL-DARDESY  63 YEARS  HUGE EXTRUDED DISC L4-5 WITH LEFT UPWARD MIGRATION.

Anamnesis

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The patient came to the clinic 02-October-2011 complaining of LBP with left sciatica for 6 months with exacerbation last 20 days down to the medial malleolus. The patient is a known diabetic for 25 years in insulin.

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MRI lumbar spine performed 22-September-2011 showing huge extruded disc L4-5 with left upward migration, resulting in severe lumbar canal stenosis.

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On examination: the patient is limping, using crutches for 10 days, has exaggerated scoliotic stance. He cannot sleep supine due to pain. There is weak dorsi and planterflexion left foot -3/5 and weak dorsiflexion right foot -4/5. SLRS was 80 degrees in  left side with pain.

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Bilateral L4-5 flavotomy with foraminotomy both L5 roots was achieved. The extruded upward migrating disc was removed from the left side in several pieces. Bilateral cleaning of L4-5 disc space was performed.

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Routine closure of the wound.  Smooth postoperative recovery  with improvement of the power of left foot.


 

 

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

Comments

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The estimated postoperative recurrence in this case is above 7%, because the disc space is still high, even bilateral cleaning was performed.

 

 

 


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