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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20-FEBRUARY-2014 MARIAM DARWEESH HALEES 62 YEARS
EXTRUDED DISC L1-2 MORE TO THE RIGHT WITH SEVERE STENOSIS AT D12-L1, L1-2 AND
The patient came to the clinic 08-February-2014
complaining of LBP for 1 year with inability to
walk more than 20 meters and weak both legs more
the right. The patient was diagnosed elsewhere
as having Guillain-Barre syndrome without
performing minimal investigations. The patient
is a known hypertensive.
On examination; the patient walking with help of
one or 2 persons. SLRS
was 70 degrees due to weak right lower limb. AJ was
absent in both sides. Babinski was positive in
the right and questionable in the left. Weak
feet 3/5 and planterflexion right foot 4/5.There
is weak right quadriceps muscle and both knees
abduction 4/5. Sensation intact.
The patient sent for MRI of the dorsal and lumbar spine
and done 08-February-2014, showing extruded disc
L1-2 more to the right and severe stenosis
D12-L1, L1-2 and L4-5.
Using C-arm, the level of L1-2 was identified.
Decompressive laminectomy D12, L1 and upper
third of L2. The disc of L1-2 was inspected from
the right side. It was compressing the crossing
root. Discectomy of L1-2 disc space with right
sided cleaning. The root then became lax and
free. Through another incision, laminectomy of
L4 and upper third of L5 with bilateral
foraminotomy both L5 roots. Routine closure of
recovery. The power of both lower limbs
There is still an estimated postoperative
recurrence around 7%, because the disc space is
still not completely shallow.
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