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.tv

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Neurosurgical Encyclopedia
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Spine Surgery Sites
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Stem Cell Therapy Site
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08-APRIL-2013  ADEL AHMAD MUSSAED  38 YEARS  RECURRENT PLD L5-S1 WITH LEFT DOWNWARD MIGRATION AND RIGHT SCIATICA.

 

Anamnesis

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The patient came to the clinic 04-April-2013 with LBP and bilateral sciatica more to the right the last 4 months down to the lateral aspect of the right ankle. The patient was operated in Egypt 2008 for bilateral sciatica more to the left. The patient is diabetic insulin dependent for 8 years.

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MRI lumbar spine done 28-March-2013 showing extruded recurrent disc L5-S1 with left downward migration. Dynamic studies were normal.

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On examination: The patient is limping with scoliotic stance. SLRS was 70 degrees in both sides with pain. Weak dorsiflexion left foot 4/5. The right AJ is absent.

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The lower half of the old incision refreshed. Foraminotomy both S1 roots. There was a huge ganglion compressing the right S1 root, which was removed. The extruded disc and upward migrating was removed lateral to the left S1 root. The disc space of L5-S1 was shallow and was not violated.

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

 

Comments

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The estimated postoperative recurrence rate around 0% because the disc space of L5-S1 is severely shallow.

 

 

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