www.neurosurgery.tv 
   

neurophysiology.ws
neurosurgery.tv
e-neuroradiology.com
onconeurosurgery.com
craniopharyngiomas.com
pituitaryadenoma.net
meningiomas.org
neuro.science

Surgical group is like a football team.

 
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

 

 

27-DECEMBER-2006  TARIQ SAIF-EDDEEN QARMASH  28 YEARS  RESIDUAL AFTER DISCECTOMY L4-5 WITH DE NOVO PLD L3-4.

The patient came to the clinic 04-October-1998 with LBP and right sciatica for 3 years after RTA. In MRI data and on examination at that time he showed an extruded disc L4-5 and was operated. He then came 28-April-1999 with clinical signs of recurrence and MRI showed a huge recurrence, for what he was operated 16-May-1999 for the recurrence.

The patient then came 17-September-2006 with LBP and right sciatica for the last week. On examination, SLRS was 30 degrees in the left and 45 degrees in the left with hypalgesia below the right knee. There was no motor deficit and the MRI performed 11-December-2006 showed only bulge disc L3-4. The patient was advised for conservative treatment.

The patient then came 11-November-2006 claiming that he was doing well , but deteriorated the last week. On examination: he was limping with scoliotic stance with SLRS 5 degrees in both sides.  He had hypalgesia below knees both lower limbs and severe weak dorsi and planterflexion both feet 3/5.  MRI performed 05-December-2006 demonstrated a huge extrusion of L3-4.

The patient was operated: laminectomy of both L3 and 4 was performed and bilateral L4 foraminotomy was done and the disc extrusion was removed lateral to the right axilla. Cleaning of the disc space was performed from the right. Inspection of the disc space from the left was negative.

Smooth postoperative recovery.

Comments:

1. Most of the population above the age of 16 years have discopathy. Here is a demonstration of how to deal with the case, when to operate for de novo extrusion and for recurrence and when another time to attack the other de novo extrusion.

 

 


Go back!Back Home!

Back Up!


     

  

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