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Munir Elias 20-12-2013
Surgical group is like a football team.

 
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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18-MAY-2010  FATIMA IZZAT ABDEL-HADY  52 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL OCCLUSION.

Anamnesis

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The patient came to the clinic 29-December-2009 complaining of LBP for 9 years with right sciatica for one year down to the heel of the right foot.

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MRI lumbar spine performed 16-September-2009 showing extruded disc L5-S1 central more to the right.

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On examination the patient can walk more than 1Km with SLRS 80 degrees both sides with weak dorsi and planterflexion right foot 4/5.

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The patient was advised to keep in conservative measures and if she deteriorate in the future then to reevaluate her condition.

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The patient then came 12-May-2010 claiming that her condition is deteriorating and the weak planterflexion right foot became 3/5 with hypalgesia right S1 root territory. SLRS was 75 degrees in the right with pain. The patient is limping with exaggerated scoliotic stance.

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The patient was sent to new MRI which was performed and demonstrating extruded disc L5-S1 with right foraminal occlusion.

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Right L5-S1 hemiflavotomy with right S1 foraminotomy was achieved. The extruded disc was removed after what the right S1 root became lax. Further meticulous cleaning of L5-S1 space was performed from the right side.

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Smooth postoperative recovery and the power of the right foot became normal..


Comments

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The patient  had extruded disc at the start, not convincing for surgical treatment. Later escalation of the events shifted the decision in favor to surgical treatment.

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In this case the disc space still not shallow, that the estimated postoperative recurrence is around 7%.

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