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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

 

 

14-DECEMBER-2006  MAHFOUZ ABDULLAH ABU-HASHEM  39 YEARS  EXTRUDED DISC L4-5 RIGHT SIDE WITH LUMBARIZATION OF S1.

The patient came to the clinic 22-November-2006  complaining of LBP for 10 years with left sciatica. The last 4 months, he progressed severe right sciatica. MRI performed 30-October-2006 showed extruded disc L4-5 with right downward migration and dehydrated L5-S1 with lumbarization of S1.

On examination: the patient was limping with scoliotic stance with SLRS 45 degrees in the right, weak dorsiflexion all toes right foot, stiff back when bending.

Right L4-5 hemiflavotomy with right L5 root foraminotomy were preformed and the extruded disc material was removed in 2 pieces lateral to the axilla. The defect in the annulus fibrosis was not small and the disc space was cleaned from the right until the sequestrated material was removed. Minimal cleaning was intentionally achieved.

Smooth postoperative recovery.

Comments:

1.  The disc space is relatively high and the defect in the annulus fibrosis was not small. The expected recurrence is relatively higher than the usual.

2.  All the running epidural veins were preserved. The good venous flow around the root indirectly confirm the absence of pressure at the foramen.  The epidural fat was transferred to the root to lower the postoperative scar formation.

 

 


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