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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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03-APRIL-2012  MAJD HUSSEIN ISSA ABDEL-MAHDY  35 YEARS  HUGE EXTRUDED DISC L5-S1 WITH MORE TO THE RIGHT EXTRUSION. 
 

Anamnesis

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The patient  was transferred from other hospital to Shmaisani hospital 02-April-2012 with history of LBP for 6 months with exacerbation the last 3 days with agonizing bilateral sciatica more to the right.

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MRI lumbar spine performed 31-March-2012 showing huge extruded disc L5-S1 with right foraminal and downward migration.

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On examination, the patient in agonizing pain unable to stand or walk.  SLRS was 5 degrees in the right and 15 degrees in the left with shooting pain. The right AJ is absent. There is profound weakness right foot dorsi and planterflexion -3/5. There is hypalgesia right L5  and analgesia right S1 territories.

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Bilateral foraminotomy of S1 roots. The extruded disc was removed first from the right side. Left sided removal was followed, then bilateral cleaning of the L5-S1 disc space was achieved. The calcified movable parts of the deformed annulus fibrosis were removed also. The epidural space was flush with Guardix-sol 1.5 g.

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Routine closure of the wound. Smooth postoperative recovery. The power of both feet became normal.

Antiadhesion solution - Genewel

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

Comments

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The estimated postoperative recurrence rate still around 7%, because the disc space is still not shallow.

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In this case bilateral removal of the extrusion was mandatory.

 

 

 

 

 

 

 

 


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