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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22-AUGUST-2011 RIFAAT ABDEL-MAJEED QAITOQA 73
YEARS LUMBAR CANAL STENOSIS DUE TO RUPTURED GANGLION RIGHT SIDE.
patient came to the clinic 15-August-2011
complaining of LBP for 1 month with weak right
lower limb after lifting heavy object. He is
using walker for 2 weeks.
lumbar spine done 13-August-2011 showing
ruptured ganglion of the right L3-4 with severe
compression of the lumbar canal at this area.
examination: the patient in wheel chair, that it
was impossible to evaluate Romberg and scoliotic
stance. There is weak dorsiflexion right foot
-3/5, left foot 3/5, planterflexion right foot
3/5, left foot +4/5. Hypalgesia right L5 and S1
territories. SLRS was 90 degrees both sides
Using C-arm, the L3-4 level
was identified and partial flavotomy around the
suggested ganglion was undertaken at L3-4. After
removing sufficient amount of the flavum, a blue
mass appeared, which was hemorrhagic and stuck
to the dura, but separable. Total removal of the
mass, which was arising from the right L3-4
facet was achieved, after what the dura became
lax and free. The mass was sent for histological
verification, to rule out malignancy.
closure of the wound. Smooth postoperative
recovery with improvement of the power of
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Rupture of the ganglion from the facets of the
vertebral column is not uncommon, but most of
them can be treated conservatively.
In this case, surgical intervention was
mandatory, to prevent the escalation of further
deterioration of the neurological status.
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 .