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Dr. Ali Al-Bayyati and Dr. Munir Elias

 
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

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23-OCTOBER-2011  AMNEH MAHMOUD ABDALLAH  56 YEARS  LUMBAR CANAL STENOSIS L3-4, L4-5 LEVELS.

Anamnesis

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The patient was operated 27-July-2010 for severe cervical stenosis, after what considerable improvement was noticed. She had also lumbar canal stenosis, which was considered to be reevaluated later.

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The patient then came 10-October-2011 claiming that the upper limbs and the neck are in good condition, but still complaining of cramps of both lower limbs  with LBP.

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MRI lumbar spine done 13-July-2011 showing severe lumbar canal stenosis L3-4 and L4-5.

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On examination: the patient is limping with scoliotic stance. There is bilateral sciatica with SLRS 75 degrees in the left with pain, but weak dorsiflexion right foot 3/5 and planterflexion right foot 4/5 and anaesthesia of right L5 and S1 territories.

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Decompressive laminectomy of L4 and partial of L3 and L5. Foraminotomy of L4 and L5 roots both sides. The right L4 foraminotomy was extended far lateral so as to decompress the severely deformed root. Only 8 mm width of the pedicle was left to preserve stability to the bony construct.

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Routine closure of the wound.  Smooth postoperative recovery  and improvement of the power of the right foot.


 

 

 

 

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

 

Comments

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The patient has lumbar canal stenosis, which is a progressive one. The surgery was postponed to resolve the cervical canal stenosis which must take precedence.

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The sooner the decompression, the better the postoperative outcome. Foraminotomy is mandatory in most cases, because the roots most of the time are compressed.


Back Up!

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 .

 

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