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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23-JANUARY-2012 NIEMEH AHMAD SALEM 75 YEARS LUMBAR
CANAL STENOSIS L3-4 AND L4-5.
relatives of the patient came to the clinic
18-January-2012 telling that their mother
complaining of LBP for more than 30 years with
deterioration the last week with inability to
walk. MRI lumbar spine performed 16-January-2012
showing severe lumbar canal stenosis L3-4 and
L4-5. The patient is a known diabetic for 10
patient was seen in the emergency of Shmaisani
hospital 22-January-2012. She is bedridden
unable to walk with severe weak both feet 3/5 of
dorsi and planterflexion.
laminectomy of L4 and partial of L3 and L5.
Foraminotomy L4, L5 roots both sides. All
compressive elements were eliminated. There is
no epidural fat at these level. There was an
extruded ligamentum flavum with ossified tissue
compressing the dural sac at L4-5 level
reaching the midline, explaining the origin of
the right sciatica. Inspection of the annulus
fibrosis at L3-4, and L4-5 made the decision not
to violate these structures.
closure of the wounds. Smooth postoperative
recovery with improvement of the power both
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The patient have lumbar canal stenosis, which is
progressing over the time. In this case there is
no alternative to surgical treatment.
The cause of sciatica to the right was due to
facet soft tissue compression from the right
L4-5 facet joint.
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 .