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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-JANUARY-2008  THURAYA DAWOOD ABDALLAH AL-SALLAL  58 YEARS  LUMBAR CANAL STENOSIS L4-5 WITH LEFT LATERAL RECESS SYNDROME.

Anamnesis:

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The patient came to the clinic 12-January-2005 with LBP and left sciatica L5 territory with intermittent claudication for several months.

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The patient is a known diabetic for 6 years and hypertensive for 10 years.

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MRI of the lumbar spine done 28-December-2004 showed bulge l%-s1 and L4-5 with segmental severe stenosis at L4-5 with foraminal stenosis more the left.

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On examination: the patient has scoliotic stance, SLRS was 70 degrees in the left with pain with almost drop left foot. She had also O.A. both knees.

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Decompressive laminectomy of L4 and partial of L5 was performed and all the compressive elements were eliminated. Bilateral foraminotomy of both L5 roots was achieved, using drilling to avoid surgical trauma to the roots. The epidural fat was missing at the most compressed levels.

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Inspection of the L4-5 annulus fibrosis showed no extrusion.

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Smooth postoperative recovery and the power of feet improved dramatically, and she was seen at the clinic 14-February-2005 with mild left sciatica and mild weak dorsiflexion left foot.

Comments

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Lumbar canal stenosis is a progressive disease and surgical intervention, prevent further deterioration from the progressive compression over the time.

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Foraminotomies must be done in most cases of LCS, because of frequent association of lateral recess syndrome.

 

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 .


 

     

  

 

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