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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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14-JANUARY-2013  MAYSERA ALI AL-FALAH  56 YEARS  LUMBAR CANAL STENOSIS L4-5 AND L5-S1.

 

Anamnesis

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The patient came to the clinic 03-January-2013 complaining of LBP for three years with bilateral sciatica more the left with intermittent claudication with inability to walk more than 200 meters. The condition is progressing.

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On examination: the patient is limping with scoliotic stance. SLRS 55 degrees in the right and 40 degrees in the left. There is weak dorsiflexion both feet 4/5 with hypalgesia left L5 territory.

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MRI lumbar spine done 02-January-2013 showing lumbar canal stenosis L4-5 and L5-S1.

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Decompressive laminectomy L5 and upper part of the sacrum and lower 2/3 of L4 until the epidural fat became visible in the upper part of the exposed field. The dura was transparent and thin due to severe compression with no epidural part at these compressed parts. Foraminotomy L5 and S1 roots both sides. The left L4-5 facet was full of ganglions and they were removed and there is 2-3 mm gap in the articular space. There is mild overmobility of this segment.

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

 

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 left sciatica which could be due to deformity of the left L4-5 facet with ganglions compressing the area and the role of overmobility of this area remain questionable as the cause of pain.

 

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Back Up!

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 .

  

 

 

 

 

 

 

 

 

 

 

 

 

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