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 .
19-AUGUST-2009 IMAN MUSA KHLEFAT 46 YEARS
LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH EXTRUDED DISC L3-4 RIGHT DOWNWARD
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient came to the
clinic 17-August-2009 with LBP for several years
and bilateral sciatica. Exacerbation of right
sciatica the last 2 months . MRI lumbar spine
performed 12-August-2009 showing lumbar canal
stenosis L3-4 and L4-5 with extruded disc L3-4
with right downward migration.
On examination the patient
has almost drop right foot with weak
dorsiflexion left foot 3/5 and planterflexion
right foot 3/5 with hypalgesia right L5 and S1
roots. SLRS was 70 degrees in the right with
pain. The patient was limping with exaggerated
Laminectomy of L4 with
partial of L3 and L5 to decompress the stenotic
canal. Inspection of the right L4 root showed
very huge extruded disc, which was migrating
downward. It was removed in several pieces.
Meticulous cleaning of the disc space of L3-4
from the right. The trail of 12 mm was
sufficient to hold the bony elements. Check
image-intensifier was acceptable. Insertion of
Satellite PEEK nucleus replacement sphere No 13
was acceptable and and it was pushed
Routine closure of the
wound and smooth
with some improvement of
the power of both feet.
Recurrence in this case could
be more than 30%, since the disc space height is
still not shallow and the defect is wide.
Insertion of PEEK Satellite nucleus replacement
sphere could decrease this incidence to below
Lumbar canal stenosis was
adding the deleterious effect of compression and
causing the severe neurological deficits. It was
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 .