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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25-DECEMBER-2012 ABDELGHANI HUSSEIN ALSARETI 43
YEARS HUGE EXTRUDED DISC L4-5 MORE TO THE LEFT WITH SECONDARY STENOSIS.
The patient came to the clinic 24-October-2012
complaining of LBP with bilateral sciatica more
to the left after falling down 10 days ago. MRI
lumbar spine done 20-October-2012 showing huge
extruded disc L4-5 central more to the left with
secondary canal stenosis. Pelvis CT-scan showing
linear fracture right iliac bone.
On examination: the patient
using 2 crutches to walk, limping with exaggerated scoliotic stance. SLRS was
degree in the left side with pain and there is
dorsiflexion both feet 4/5.
The patient then came
24-December-2012 with left sciatica but SLRS was
80 degrees with still weak dorsiflexion both
Complete laminectomy of L4
and partial of L5. Bilateral foraminotomy L5
roots. There is no epidural fat due to severe
compression. Bilateral intradiscal cleaning L4-5
until the central extrusion was pushed to the
disc space and removed from both sides. Most of
the posterior part of annulus fibrosis was
removed to decrease the postoperative
Routine closure of the wound.
The power of both feet became normal.
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The patient had an
estimated postoperative recurrence rate around
7%, because the disc space height is still not
Most of the posterior part of annulus fibrosis
was removed to decrease the postoperative
recurrence from both sides. Time will tell if
this manipulation can decrease the recurrence.
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