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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

 
15-AUGUST-2006  WA'EL DARWEESH MUSTAFA  37 YEARS  HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION
The patient came 13-August-2006 complaining of LBP for 6 months  with left sciatica for 1 month and numbness left L5 territory. MRI done 05-August-2006 showing huge extruded disc L4-5 with left downward migration and bulge L5-S1.

On examination: SLRS was 20 degrees in the left with pain with exaggerated scoliotic stance and drop left foot. The patient was advised to undergo surgery.

Left L4-5 hemiflavotomy with left L5 root foraminotomy was performed and the axilla was inspected, under which the downward migration was seen and removed from there, after what the root became relaxed.  The root then was shifted medially and the old centrally extrusion was removed with further cleaning of the disc space was done.

Prompt postoperative recovery.  

Comments:

1. Considering that the old part of the extruded disc in the central localization was mobile, it was necessary to attack the disc space lateral to the axilla to perform intradiscal cleaning to gain more relief of the root. This step could increase the rate of recurrence, but it was necessary to do to obtain maximum decompression of the root.


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