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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

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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

07-MARCH-2011  HUSNIEYH NAJAH JNEYD  44 YEARS  HUGE RECURRENT PLD L4-5 LEFT SIDE.

Anamnesis

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The patient was operated by me 10-April-2007 for extruded disc L4-5 with right  downward migration causing severe right sciatica. Then the patient came several times with neck and back pain for what, MRI of the lumbar spine performed 18-November-2007 ruled out the presence of recurrence. MRI cervical spine performed 27-October-2010 showed small PCD C5-6 and dorsal spine showed small PDD D4-5.

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The patient then came 13-February-2011 complaining of LBP with left sciatica and difficult walking.

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On examination: the patient is limping, walking bended foreword. SLRS was 5 degrees both sides with pain more the left. There is hypalgesia right L5 root with almost drop left foot

bullet MRI lumbar spine done 19-February-2011 showing huge recurrence L4-5 left side.
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Left L5 root foraminotomy. The root was severely compressed by the extruded fragment, which was removed lateral to the axilla. Left sided cleaning L4-5. There was no epidural fat at the axilla due to previous compression. The root is hanging free.

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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 patient in the first surgery had trauma to the bone structures in the disc area and a bone chip was inserted from the right after removing the extruded disc.

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The recurrence took place from the left, which is unusual, but considering that the previous surgery had unusual findings, this recurrence could be expected to be from the contralateral side.

 


 

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