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
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12-DECEMBER-2012 ATTA MUHAMED ABDEL-RAHMAN 46 YEARS EXTRUDED DISC L3-4 WITH
The patient came to the clinic 08-December-2012
complaining of LBP for many years with
exacerbation last 3 years with left sciatica and
bilateral sciatica for 1year with pain and
numbness all toes right foot. He cannot walk
more than 200 meters. The patient is a known
hypertensive underwent CABG 18 months ago.
On examination: the patient
is limping in agonizing pain with
exaggerated scoliotic stance. SLRS 60 degrees
right side and 55 degrees in the left with pain. There is
weak dorsiflexion both feet -4/5. There is
hypalgesia right L5 territory.
MRI of the lumbar spine done
showing extruded disc L3-4 with left downward
migration causing severe segmental stenosis.
Decompressive laminectomy L3
and upper third of L4. Bilateral foraminotomy
both L4 root. There were 2 separate dural
defects, which were closed by 6 zero nylon.
Bilateral removal of the extrusion and bilateral
cleaning of L3-4 disc space.
Routine closure of the wound. Smooth
postoperative recovery. The power of both feet
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The patient still has
an estimated postoperative recurrence rate
below 7%, because the disc space is still not
completely shallow and the stress is less than
the underlying disci.
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