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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  came to the clinic one moth ago with clinical picture of LBP for several months and right sciatica. The patient had weak dorsiflexion right foot with hypalgesia of the right L5 territory with intermittent claudication. MRI performed and showed elements of segmental stenosis L4-5 with extruded disc  L4-5 with right downward migration. The condition of the patient was not striking for surgery and it was recommended to give a trail for conservative treatment.

The patient then came after one month and she was claiming that, her condition is deteriorating and she became unable to ambulate, despite the conservative measures.

The patient then was operated. Bilateral flavotomy of L4-5 with right L5 foraminotomy was done. The extruded piece was removed from under the axilla and the disc space with wide-based fragment was removed from the right side with meticulous cleaning of the disc space.

Comments:

1. After removal of the extrusion from under the axilla, the nerve was still tight with annulus fibrosis still compressing the nerve from behind. Despite the fact that it was glistening, but the wide-based extrusion was sharing the compressing elements in the root from anterior, for what cleaning of the disc space was performed.

 


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