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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

 

 

25-DECEMBER-2006  LAM'EEA HUSSEIN AL-HASANI   73 YEARS OSTEOMYELITIS OF L4,5 WITH DISCITIS UNKNOWN CAUSE. STATUS AFTER DISCECTOMY L4-5 3 MONTHS AGO.

The patient an Iraqi citizen came to the hospital 1 month ago with a history of discectomy L4-5 2 months ago in Syria. MRI performed before surgery showed only elements of segmental stenosis at L4-5. MRI performed upon admission were that of osteomyelitis of L4 and 5 bodies. The patient was investigated for septic work and she was discharged under long-term therapy with dalacine 300 mg twice a day. Dalacine caused diarrhea, for what it was stopped 2 days ago.

The patient then came 24-December-2006 for follow up and she got mild improvement of her clinical signs with SLRS 30 degrees in the right and 40 degrees in the left with weak dorsi and planterflexion of the toes right foot with hypalgesia of the right L5 territory. MRI performed 20-December-2006 showing worsening of the morphologic picture, for what it was decided to admit her for thorough investigations.

Under G.A. percutaneous discectomy of L4-5  from the left side was performed and attempts were created to obtain the disc and bony material for histological and all possible causes including tbc. 

27-December-2006: The investigations ruled out the presence of tumor or tuberculosis and the patient was put in ciproflacine instead of dalacine.

Comments:

1.  To my knowledge, I was the first in Jordan who introduced percutaneous discectomy 15 years ago. During 4 years period, I performed 8 operation in the first year, then 6 operations the second and 4 operations the third and 2 operations the fourth year.  It became clear that, percutaneous discectomy have no place in disc treatment  and it was abandoned by me, because bulging disc needs only rest for a couple of weeks to subside. I use this technique only for special circumstances, such as in this case

 

 


 


  

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