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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

 

10-SPTEMBER-2006  BASIMAH ABDEL-HAFEZ SALEH  46 YEARS LCS L2-3, L3-4 AND L4-5 WITH LATERAL RECESS SYNDROME LEFT SIDE.
 

The patient came 31-July-2003 complaining of LBP for 12 years  with bilateral sciatica for 1 year more to the left. She could not walk more than 100 meters with intermittent claudication.  She is a known hypertensive for 2 years. ESR performed 19-December-2005 was 50 mm/h.

On examination: the left AJ is absent  with weak dorsiflexion both feet and planterflexion left foot. MRI lumbar spine with MR myelography was requested and performed 01-August-2006 showing bulge L4-5 with old collapse of L3-4 disc space, resulting in LCS L2-3, L3-4 and L4-5.

Decompressive laminectomy L3-4 and partial of L5 was performed and foraminotomy for L4 and L5 roots both sides was done. There was a severe lateral recess syndrome left side, which was dealt accordingly. The left L4 root was severely compressed and the epidural fat near that area was rubbery in consistency, denoting that some inflammatory process took place in the past. Inspection of the disc spaces were negative for presence of extruded fragments.

Routine closure of the wound with smooth postoperative recovery.

Comments:

1.  LCS is a pathological entity, that could be silent, until some pathologic process provoke it, such in this case. Considering the relative young age of patient, the precipitating factor could be a hidden inflammatory process, which triggered the escalation of the clinical picture. 


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