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
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16-JULY-2011 JAMAL ABDEL-RAHMAN ABDEL-RAB 53 YEARS
RECURRENT EXTRUDED DISC L5-S1 RIGHT SIDE.
patient was operated elsewhere 2007 for PLD
L5-S1 for left sciatica, but after surgery
progressed right sciatica. The patient came to
05-July-2011 complaining of LBP with
right sciatica which increased the last 2 months
with numbness of the right L5 territory.
spine done 19-April-2007 before the surgery showing extruded disc
L5-S1 right side. MRI lumbar spine repeated
15-July-2007 after surgery showing recurrent
extrusion L5-S1. MRI lumbar spine done
04-July-2011 showing extruded disc L5-S1 with
right downward migration.
examination: the patient was limping with
scoliotic stance and
weak dorsiflexion right foot 3/5 and
planterflexion -4/5. There is dyseasthesia right
L5,S1 territories. SLRS was 75 degrees with
Right S1 foraminotomy was
done. The massive scar was removed from the
right side down to the foraminotomy site. Check
image-intensifier was used to locate the site of
dissection. The extruded downward
migrating disc was adherent to the right S1 and
S2 roots. Sharp dissection was necessary to free
the roots of the extrusion. The extrusion was
removed in several pieces and further cleaning
of L5-S1 disc space was achieved from the right.
closure of the wound. Smooth postoperative
recovery with normalization of the power of the
right foot with disappearance of right
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The estimated postoperative recurrence rate is
below 7% because the disc space of L5-S1 is shallow.
The patient had recurrence even immediately
after surgery, if it was not removed, but it could changed in
consistency, shape and new recurrence took place
the last 2 months.
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 .