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.tv
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14-JANUARY-2013 MAYSERA ALI AL-FALAH 56 YEARS LUMBAR
CANAL STENOSIS L4-5 AND L5-S1.
Anamnesis
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.
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.
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.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
feet became normal.
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Comments
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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