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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05-JUNE-2002 FIKRY ABDEL-RAHEEM SAABNEH EXTRUDED DISC L4-5 WITH LEFT
The patient came to the clinic 02-June-2002
complaining of LBP with left sciatica for 23
years. He was operated three times for PLD L5-S1
in 1990 without improvement with subsequent
infection. The last 5 months got exacerbation of
the LBP and left sciatica.
MRI lumbar spine done 30-May-2002 showing
huge extruded disc L4-5 with left downward
On examination: The patient is limping with
exaggerated scoliotic stance. SLRS was
degrees in the right with pain and 30 degrees in
the left with more pain. There is missing left
AJ with weak dorsiflexion 3/5 and planterflexion
4/5 of the left foot with hypalgesia left
L5 and S1 territories.
Lower 2/3 ofL4 was done and
laminectomy of the remnant of L5 was done with
scarolysis. Bilateral L4-5 flavotomy was done
because there was severe segmental stenosis at
this level. Left L5 foraminotomy was done. The
huge extruded disc was removed in one big piece
and several small pieces lateral to the axilla.
Left sided intradiscal cleaning of L4-5 disc
space. The left S1 root was explored
Routine closure of the wound.
Smooth postoperative recovery. The power of the
left foot became normal.
There is still an estimated postoperative
recurrence above 7%, because the disc space is
still not shallow.
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