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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
11-NOVEMBER-2010 WAFIQA HAMDY AL-LABABIDI 80 YEARS
LUMBAR CANAL STENOSIS L1-2, L2-3 WITH EXTRUDED DISC L2-3 LEFT SIDE.
was operated by me 08-December-2003 for severe
cervical canal stenosis C3-4, 4-5 and 5-6. She
was then operated by me
for lumbar canal stenosis L3-4 and L4-5.
patient then came 14-September-2010, complaining
of LBP with left sciatica for 2 years and
inability to stand for more than 5 minutes or
walk more than 30 meters.
examination: The patient walking bended
with SLRS 80 degrees in the left with pain.
There is weak dorsiflexion right foot -4/5 and
3/5 left foot with
analgesia below the both knees and hypalgesia
spine performed 29-September-2010 showing severe
lumbar canal stenosis at L1-2, L2-3 with
extruded old disc L2-3 left side. The
patient was seen by cardiologist and cath done,
which showed stenosis 70% of the left anterior
Decompressive laminectomy of L1,2 with removal
of the remnants of L3 and foraminotomy of left
L3 root was achieved. There was no
epidural fat and the dura was transparent, that
the roots could be seen through it. The left L3
root was adherent to the surrounding structures.
It was dissected off to remove the extruded disc
of L2-3 from the left lateral to the axilla.
After removal of the extrusion and cleaning of
the disc space, CSF leak took place from a tiny
dural defect lateral to the axilla. Nylon 6 zero
2 stitches were used and aided with 2 layers of
muscle were applied to get secure closure of the
defect to prevent postoperative CSF leak.
Valsalva maneuver and putting the head above the
operative field level confirmed no CSF leak.
closure of the wound. Smooth postoperative
recovery and improvement of the power of both
The patient has lumbar canal
stenosis with old extruded disc at L2-3 left
Decompression must include
the ongoing stenosis at L1-2, so as to avoid
further surgery in the near future.
Severe compression with
adherent tissues can complicate the surgery with
presence of dural defects, which were triggered
This is a typical example
about the progressive nature of canal stenosis
with cervical component was the starting point
and then the lower lumbar, then the upper lumbar
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
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 .