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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31-JANUARY-2008 HANAN MUHAMED ZEDAN 45 YEARS HUGE
RECURRENT PLD L4-5 WITH RIGHT DOWNWARD MIGRATION.
The patient came to the
clinic 29-January-2008 with agonizing right
sciatica and LBP for three months.
The patient was operated
elsewhere June-2006 for the same sciatica and
discectomy of L4-5 was performed. The patient
noted slight improvement of her sciatica.
MRI performed 23-January-2008
showing huge recurrence at L4-5 with right
On examination: the patient
is limping and has scoliotic stance. SLRS was 45
degrees in the right and 75 degrees in the left
with radiating pain to the right leg. The
patient had almost drop right foot with weak dorsiflexion right foot
1/5. There was numbness at S1 root territory
The old incision was
completely above the projection of the problem,
for what another incision was performed under
the old incision.
Neurolysis of the right L5
root was achieved and the extruded disc was
removed lateral to the axilla.
Meticulous cleaning of the
disc space of L4-5 from the right. Inspection
under the axilla for remnant of the extrusion
Routine closure of the wound
and smooth postoperative recovery with
normalization of the power of the right foot.
Foraminotomy of the involved
root must be done in all disc surgeries to be
sure that there is no remnant left under the
The skin incision must be
adequate so as to ease the surgery. Working with
inadequate skin incision, could mislead the
surgeon and make the angle of vision more
The annulus fibrosis was
widely violated from the first surgery, but the
disc height was narrower, these controversies
make the expected rate of re-recurrence around
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014