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Dr. Ali Al-Bayyati and Dr. Munir Elias

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.fr

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25-DECEMBER-2012  ABDELGHANI HUSSEIN ALSARETI  43 YEARS  HUGE EXTRUDED DISC L4-5 MORE TO THE LEFT WITH SECONDARY STENOSIS.

 

Anamnesis

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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.

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On examination: the patient using 2 crutches to walk, limping with exaggerated scoliotic stance. SLRS was 0 degree in the left side with pain and there is weak dorsiflexion both feet 4/5.

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The patient then came 24-December-2012 with left sciatica but SLRS was 80 degrees with still weak dorsiflexion both feet 4/5.

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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 recurrence.

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Routine closure of the wound. The power of both feet became normal.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

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The patient had an estimated postoperative recurrence rate around 7%, because the disc space height is still not shallow.

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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.

Leica HM500

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Back Up!

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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[2012] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved