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Surgical group is like a football team.

 
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

 

 

09-OCTOBER-2006  ALI JUMAA AHMAD   25 YEARS  EXTRUDED DISC L5-S1 RIGHT SIDE

The patient came to the clinic 3-October-2006 complaining of LBP for 8 years with right sciatica. Exacerbation the last week with positive cough sign. He was limping with scoliotic stance.

On examination: SLRS was 30 degrees in the right and 45 degrees in the left with weak dorsiflexion right foot and hypalgesia right L5 and S1 territories.

MRI lumbar spine performed 04-October-2006. It showed extruded disc L5-S1 with right downward migration.

Right L5-S1 hemiflavotomy  with foraminotomy of right S1 root was done. The extruded disc was removed and it was necessary to violate the annulus fibrosis to remove the extrusion with further cleaning of disc space from the right side. There was a small tear in the root with small bulge of the arachnoid without CSF leak. It was coagulated and the tear disappeared.

Routine closure of the wound.

Comments:

1.  The disc space is narrow which is considered a good predictor for lower rate of recurrence. The annulus fibrosis was attacked for 8-9 mm wide which is a negative predictor.

2. The presence of dural tears must not be considered all the time from surgery. They can be from severe compression in some points of maximum compression.  If they are small such in this case, coagulation of the point or the tear is sufficient.

 

 


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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved