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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25-JANUARY-2012 UMAT-AL-GHUFOUR MUHAMED MDAAES 38 YEARS
HUGE EXTRUDED DISC L3-4 WITH RIGHT DOWNWARD MIGRATION.
patient a Yemeni citizen came 21-January-2012 complaining of LBP
and right sciatica for 2 months down to the
right L5 territory with progressive course. MRI
lumbar spine done 11-December-2011 showing
extruded disc L3-4 with right downward
examination, the patient is limping with
exaggerated scoliotic stance. SLRS was 70
degrees with pain the right with weak
dorsiflexion 3/4 and planterflexion -4/5 right
foot. The right quadriceps femoris was 4/5.
MRI of the
lumbar spine was repeated
22-January-2012 which confirmed the presence of
huge extrusion of L3-4 with right downward
Using C-arm, the L3-4 level
was identified. Through 3 cm incision,
foraminotomy of right L4 root was done. The root
was severely compressed by hard extrusion, which
was removed lateral to the axilla. Right sided
cleaning of L3-4 disc space. The dura was
severely transparent and it was coagulate at one
site to prevent possible CSF leak and this place
was aided with muscle.
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
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The patient has large extrusion which was
causing severe compression of the root and the
dura was so thin, that it could rupture, if
attention to this not paid.
The estimated postoperative recurrence still
around 7% because the disc space is still not
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 .