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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27-FEBRUARY-2010 HUDA ABDEL-AZZIZ ALIAN 63 YEARS
SEVERE LUMBAR CANAL STENOSIS L3-4 AND L4-5.
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patient came to the clinic 09-December-2009
complaining of LBP for 35 years of intermittent
course. Two months ago felt down, after what
exacerbation of LBP and bilateral leg numbness.
She is incontinent for urine and defecation for
one month. She has intermittent claudication and
could walk less than 50 meters.
MRI of the lumbar
spine performed 26-February-2010 showing
severe lumbar canal stenosis L3-4 and L4-5 with
old spondylolisthesis L4-5 and fused L4-5.
On examination: the patient
is limping with exaggerated scoliotic
stance. SLRS was 80 degrees with pain both sides. Hypalgesia
both feet due to diabetic neuropathy up to the
is weak dorsiflexion 4/5 of both feet.
Decompressive laminectomy L4
and partial of L3 and L5 was performed and
foraminotomy of both L5 roots was achieved.
Check for instability confirmed slight
overmobility at L3-4 level, but L4-5 was stable
due to fused L4-5 disc.
Routine closure of the wound.
recovery, and the power of both feet
The disc space of
very shallow, for what the spondylolisthesis was
an old one and there is no overmobility at this
The surgery was
indicated for L4-5 and decompression of L3-4 was
precautionary to prevent near future escalation
of the stenosis. The overmobility was at L3-4
level, for what it was ignored.
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 .