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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-APRIL-2013  ABBUD ABDEL-QADER ALSABHA  33 YEARS  HUGE EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 24-April-2013 complaining of LBP for 6 years with  right sciatica for 2 months down to the medial malleolus right ankle. MRI of lumbar spine done 25-February-2013 bad quality, but showing huge extruded disc L5-S1 compressing the right S1 root.

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On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 20 degrees right side with pain and 80 degrees in the left . There is weak dorsiflexion right foot -4/5.

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The patient was sent for investigations. MRI of the lumbar spine done 24-April-2013 showed huge extrusion L5-S1 with right foraminal and far downward migration.

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Right S1 foraminotomy with preservation of the ligamentum flavum. The extruded disc was removed from under the axilla in several big pieces, after what the swollen root became free from any compression. The disc space of L5-S1 was meticulously cleaned from the right side.

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Routine closure of the wound. Smooth postoperative recovery.  The power of right foot became normal.

 

 

Comments

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The patient still has an estimated postoperative recurrence below 7%, because the disc space height is not completely shallow.

 

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