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Dr. Ali Al-Bayati

 
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

 

The patient  came to the clinic 22-February-2006 with agonizing sciatica right side and drop right foot with weak planterflexion right foot and hypalgesia right S1 territory. MRI of the lumbar spine showed lumbarization of the sacrum with extruded disc L5-S1 right side.

The patient was operated the next day. Right L5-S1 hemiflavotomy and foraminotomy of the right S1 root was performed. The extruded disc was removed lateral to the root. It was adherent to the veins, for what it was necessary to coagulate the veins, which usually I preserve them.

Inspection of the lateral wall of the annulus fibrosis, revealed, that it is movable, and it could cause pain to the patient after surgery, for what, all the movable part of the annulus fibrosis was removed. Considering that the disc space opening was wide, meticulous cleaning of the disc material from the space was performed, to lower the incidence of recurrence.

Dramatic postoperative recovery and the patient discharged the next day. 

Comments:

1. The recently, accepted policy to remove the extrusion and to remove lesser disc material without widening the hole, through which minimal cleaning of the disc space, not all the time is possible. Here a demonstration that the movable part of the annulus fibrosis must be removed, creating by that a large defect in the wall of the disc space.

2. In that case a meticulous cleaning of the disc space is mandatory, to lower the incidence of the recurrence.

 


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