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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28-MAY-2012 ALAA BASEM AL-SHAREEF 24 YEARS
EXTRUDED DISC L5-S1 WITH LEFT FORAMINAL OCCLUSION.
Anamnesis
The
patient came to the clinic 19-March-2012
complaining of left sciatica for 10 months down
to the calf muscle with a progressive condition.
MRI lumbar spine performed 19-September-2011
showing extruded disc L5-S1 with left foraminal
occlusion. The patient is overweight 120 Kg.
On
examination, the patient is limping with
exaggerated scoliotic stance. SLRS was 40
degrees in the right with shooting pain to the
left and 5 degrees in the left with more pain.
The left AJ was absent and there is weak
dorsiflexion left foot 3/5.
The
patient was sent for new MRI lumbar spine which
was done 22-May-2012 showing the extruded disc
L5-S1 with left foraminal occlusion and downward
migration.
Left S1 foraminotomy with
partial L5-S1 flavotomy. The patient is very
obese and the wound is very deep, that all the
instruments were with difficulty reaching the
working area and video production is difficult.
The extruded disc was removed lateral to the
axilla and left sided cleaning of L5-S1 disc
space was achieved. Guardix-sol 1.5 was applied
to decrease postoperative fibrosis.
Routine
closure of the wound. Smooth postoperative
recovery and the power of the
left foot
became normal.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
connection.
Comments
The patient still
have an estimated postoperative recurrence
around 7% because the disc space height still
not shallow.
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 .
