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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  AMEEN SALTI QAQISH  32 YEARS  HUGE EXTRUDED DISC L4-5 WITH WIDE BASE AND RIGHT FORAMINAL OCCLUSION.

 

Anamnesis

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The patient is a doctor came to the clinic 06-April-2013 complaining of LBP for 4 months with  right sciatica down to the lateral malleolus right ankle. MRI of lumbar spine done 03-April-2013 showing huge extruded disc L4-5 wide based compressing the right L5 root with right downward migration.

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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 and dorsiflexion left foot and planterflexion right foot 4/5. The right AJ is diminished.

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Using C-arm, the L4-5 level was identified and right L4-5 hemiflavotomy was done and right L5 root foraminotomy achieved. The area was lacking an epidural fat due to severe compression. The extruded disc was removed lateral to the axilla. Right sided cleaning of L4-5 disc space.

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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 is still not completely shallow.

 

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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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