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The group in action.

 
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

 
22-MAY-2006 MUHAMED SALEH KHARMA 67 YEARS LCS L3-4 AND L4-5 WITH LEFT LATERAL RECESS SYNDROME.
The patient came to the clinic 15-June-1999 complaining of intermittent claudication for 5 years  with progressing course. On examination at that time he had no motor or sensory deficit. MRI with MR Myelography of the lumbar spine requested and the patient disappeared.

The patient then came 11-November-2001 with numbness of the left lower limb after bending with sciatica. MRI done 10-November-2001 showed extruded disc L3-4 with segmental stenosis at L3-4 and L4-5. He was limping  with SLRS 45 degrees in the left with hypalgesia of the entire anterior thigh  and foreleg with weak adductors and abductors of the left knee and quadriceps femoris left leg. The patient was advised to undergo surgery but he disappeared another time.

The patient came 06-May-2006 with intermittent claudication with dripping of urine for 3 months with inability to walk even 10 meters with weak planterflexion both feet more the left. MRI of the lumbar spine requested and performed which showed LCS L3-4 and L4-5 with the previous extrusion shrunken, but the left lateral recess syndrome took over.

The patient was operated and decompressive laminectomy L4 and partial of L3 and L5 was done. Foraminotomy of the left L4 root was performed. Exploration of the L3-4 disc showed that, it is not necessary to violate it. Routine closure .

Prompt postoperative recovery.

Comments:

1. The patient over the time can change the clinical picture and the strategy for surgery accordingly.

2. Time will show, how the delay, in surgery taking decision, could affect the level of recovery.


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