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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 was seen 09-January-2006 complaining of LBP for 4 years  with exacerbation of the pain and bilateral sciatica the last year. Numbness both feet for 5 months and inability to walk more than 200 meter without intermittent claudication. He is  a known hypertensive for 4 years. He has also gout and underwent stinting for cardiac problems in April-2004.

On examination, he had hypalgesia of the right foot with hypalgesia of the left lower limb up below the knee. He had weak dorsiflexion both feet  and planterflexion left foot. MRI was performed 05-July-2005 showing LCS L3-4 and D11-12. The patient was sent for another MRI and the stenosis was not striking at L3-4 with elements of stenosis at L1-2 and L2-3. The stenosis at D11-12 was due to old disc extrusion in the right side.

The patient was advised to undergo conservative treatment and to be followed. In case of deterioration, then surgery to be performed. The patient came 22-March-2006 with marked deterioration of his neurological signs with cauda equina syndrome and hypalgesia below the knees both sides and micturition problems for 2 days.

Laminectomy of L2-3 and partial of L4 and 1 was performed and foraminotomy of both L2-3-4 roots was achieved. Decompression was done at the all mentioned levels. The old extrusion at D11-12 was checked by inserting feeding tube No 10 to rule out the presence of any resistance. The impression was negative. Routine closure of the wound.

Smooth postoperative recovery. The patient the next day showed normalization of the power of both lower extremities and recovery of sensation of the right lower limb with decrease of the sensory deficit to the left foot.


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