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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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Multigen RF lesion generator .

13-FEBRUARY-2012  BUTHAYNA KAMEL MUHAMED  29 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

Anamnesis

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The patient came to the clinic 11-January-2012 complaining of LBP for 5 years with left sciatica for 3 months. The last week the left sciatica disappeared and shifted to the right lower limb, down to the heel.

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MRI lumbar spine performed 25-October-2011 showing central small extrusion L5-S1. Cervical MRI showing small PCD C5-6.

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On examination, the patient is limping with exaggerated scoliotic stance. SLRS was 30 degrees in the right with pain. There is weak dorsiflexion right foot 4/5 and planterflexion -4/5 same foot. There is hypalgesia right L5 root territory. The AJ is absent in the right.

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The patient was sent to another MRI of the lumbar spine, which was performed 31-January-2012, which showed extruded disc L5-S1 with right downward migration.

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Right S1 foraminotomy with partial right L5-S1 flavotomy. There is missing epidural fat at the area of severe compression. The extruded downward migrating disc was removed subaxillary. Right sided cleaning L5-S1 disc space, The root regained lax position. There was Tarlov cyst in the lower corner of the field originating from the dural sleeve, which was inspected and left in place.

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Routine closure of the wounds. Smooth postoperative recovery with normalization of the power of the right 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 still have possibility to progress recurrence around 7%, because the disc space is still not shallow.

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Tarlov cyst is a coincidental finding, which must not be violated.


 

 


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