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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

 

29-AUGUST-2006  FATEMAH DAWOOD SALMEEN  45 YEARS  LCS L4-5 WITH LESSER DEGREE OF L3-4.

The patient came 27-August-2006 complaining of LBP for 4 months with bilateral sciatica , more the right  and inability to walk more than 20 meters with intermittent claudication.  The patient is under treatment for lupus with prednisolone  5 mg for 10 years, with hypertension for 4 years, hypercholesterolemia  and diabetes mellitus  for 4 years  and in L-thyroxin 50 microgm daily for 5 years.

MRI done 28-June-2006  showing severe LCS L4-5  with minimal stenosis L3-4.  On examination: the patient had weak dorsi and planterflexion both feet, more the right with atrophy of both gastrocnemius muscle both forelegs and severe OA both knees. Weak knee abduction 3/5 both sides.

Decompressive laminectomy L4 and partial of L3 and L5 was performed and foraminotomy of both L5 roots was achieved. Inspection of the foramina for any residual compression was negative and the L4-5 disc was inspected and it was glistening without any extrusion.

Prompt postoperative recovery.  

Comments:

1. It was explained to the patient, that she has plenty of medical problems, which cannot be resolved by surgery. Since the LCS is a progressive one; this part of her many problems must be corrected by surgery to prevent further deterioration caused by this severe stenosis.

2. Considering that the patient has many problems and cortisone can lead to further escalation of the stenosis at the above level, decompression of L3-4 was corrected to prevent further surgery in the near future.


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