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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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05-MAY-2012  FATMEH FAYYAD AL-LAWZY  55 YEARS SEVERE LUMBAR CANAL STENOSIS L3-4, L4-5.

 

Anamnesis

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The patient  came to the clinic 25-April-2012 complaining of numbness both feet for 5 years with intermittent claudication and inability to walk more than 50 meters. The condition is deteriorating and having LBP with bilateral sciatica. MRI lumbar spine performed 09-January-2009 showing severe stenosis L3-4 and L4-5.

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On examination, the patient is limping with exaggerated scoliotic stance with SLRS 70 degrees with pain in the right side. There is weak dorsi and planterflexion both feet 4/5. The right KJ and left AJ are absent. The pedis dorsalis and femoral pulses were impalpable.

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The patient was sent for new MRI lumbar spine and CT-angio of the aorto-ilio-femural arteries. They were performed 27-April-2012 showing good filling of all arteries, except the pedis dorsalis and severe stenosis L3-4 and L4-5.

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Decompressive laminectomy L3,4 and upper half of L5. Flavotomy L2-3 and foraminotomy L4, L5 roots both sides. The epidural fat was missing all over. No signs of instability. The disc structures were acceptable, not violated. The roots hanging free.

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Routine closure of the wound. Smooth postoperative recovery. The power of the feet normalized.

 

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Comments

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The patient has lumbar canal stenosis of a progressive course. Surgical decompression is the only solution in this case.

 

 


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